Complain about a product or service

PSA Test Still Useful in Prostate Cancer Care, Study Finds

September 14, 2005
Despite recent claims by some urologists that measuring the blood protein prostate-specific antigen (PSA) may not be effective in predicting risk of prostate cancer, a Johns Hopkins study of more than 2,000 men confirms that PSA remains the best measure of the likelihood of cancer recurrence after surgery.

• Study Links Prostate Cancer to Single Rogue Cell • PSA Testing May Be Unnecessary for Some Older Men • Compound Can Identify Prostate Cancer • Improved PSA Tests May Better Determine Prostate Cancer Risk • Vitamins Don't Cut Prostate Cancer Risk • Aspirin May Lower PSA Levels in Men • FDA Approves New Overactive Bladder Drug • New Prostate Surgical Techniques Often "Over-Promoted" • Feds Approve Drug for Enlarged Prostate • New Prostate Cancer Treatment Shows Promise • Broccoli Reduces Prostate Cancer Risk, Study Finds • Celebrex-Lipitor Combo May Halt Prostate Cancer • Exercise May Speed Prostate Tumor Growth • Soy Compound May Halt Spread of Prostate Cancer • Obesity Linked to Higher Prostate Cancer Mortality • Red Wine May Fight Prostate Cancer • Enlarged Prostate Doesn't Mean Cancer • Hopkins Researchers Claim Better Blood Test for Prostate Cancer • Severe Form of Enlarged Prostate Disease Discovered • Tomato-Broccoli Combo Can Help Shrink Prostate Cancers • Weight Gain Increases Risk of Dying from Prostate Cancer • Smoking Linked to Complications in Prostate Cancer Treatment • Newer Approach Urged in Screening for Aggressive Prostate Cancer • Aspirin May Prevent or Delay Enlarged Prostate • Hopkins Researchers Find Better Blood Test for Prostate Cancer • Prostate Radiation May Cause Problems Later • New Test Detects Prostate Cancer Spread Earlier • Castration May Be Advised in Advanced Prostate Cancer • Radiation Therapy May Be Best for Younger Prostate Cancer Patients • Study Recommends More Prostate Biopsies • Delayed Surgery May Be OK for Some Prostate Cancer Patients • Study: PSA Test Doesn't Improve Prostate Cancer Survival Rate • Prostate Cancer Genes Identified • Annual Prostate Cancer Screening Test Appears to Save Lives • FDA Panel Rejects Prostate Cancer Pill • PSA Test Still Useful, Hopkins Study Finds • No "Normal" PSA Level: Study • New Prostate Cancer Test Shows Promise • Lifestyle and Diet May Stop or Reverse Prostate Cancer Progression

Results of the study, published in the October issue of The Journal of Urology, demonstrated that men with high PSA levels prior to prostate removal surgery were significantly more likely to have advanced clinical stages of cancer, evidence of higher grade cancers in surgically removed tissue, and spread of cancer cells beyond the prostate.

In addition, increasing PSA was significantly associated with increased risk of cancer recurrence after surgery, even in men with lower PSA levels prior to surgery.

The study was led by Stephen J. Freedland, M.D., clinical instructor of urology, and Alan W. Partin, M.D., Ph.D., professor and chair of urology at Johns Hopkins' Brady Urological Institute.

"In our study, PSA levels measured before prostate removal surgery were significantly associated with the risk of recurrent cancer after surgery," Freedland says. "These data support the notion that PSA remains the best available prostate cancer tumor marker. It certainly suggests that the PSA era is alive and well."

PSA is a protein produced by cells of the prostate gland. Prostate cancer can increase PSA, so the higher the PSA level, the greater the likelihood that a patient has prostate cancer. Also, higher PSA values generally reflect larger, more aggressive cancers.

Freedland acknowledges that because PSA provides physicians with a measure of a patient's prostate health at a single point in time, it's "far from perfect." However, he says, "it's better than anything else we have."

"As a screening tool, PSA has done what we wanted it to do," Freedland says. "It detects advanced disease early and reduces the likelihood of metastatic disease."

For the study, Freedland and colleagues reviewed patient records for 2,312 men who had prostate removal surgery at Johns Hopkins between 1992 and 2004. The research team compared the association between preoperative PSA and the risk of cancer recurrence after surgery.

During an average follow-up of five years, 211 men (10 percent) had signs of recurrent cancer. Higher PSA levels prior to surgery were significantly associated with increased risk of cancer after surgery.

Compared with men with PSA levels less than 10 nanograms per milliliter, men with PSA values between 10 and 19.9 nanograms per milliliter were more than three times more likely to develop cancer after surgery. Men with PSA levels of 20 nanograms per milliliter or greater were more than five times more likely to develop cancer after surgery than those with low PSA levels.

Even in men with PSA values of less than 10 nanograms per milliliter, increasing PSA was significantly associated with increased risk of cancer after surgery. For each two-point increase in PSA, the risk of cancer after surgery approximately doubled.

"From our study and others, it is clear that a single PSA value is an extremely useful measure of a patient's risk of progression after surgery," Freedland says. "However, looking at how quickly the PSA increases over time is likely to be even more informative than a single value."

Report Your Experience
If you've had a bad experience -- or a good one -- with a consumer product or service, we'd like to hear about it. All complaints are reviewed by class action attorneys and are considered for publication on our site. Knowledge is power! Help spread the word. File your consumer report now.

Share		Follow us on Twitter.