Recurrence of prostate cancer still tough to diagnose
After being diagnosed of prostate cancer, one often thinks the cancer’s stage determines the kind of treatment, but researchers note that it might not be an important factor in predicting the recurrence of non-spreading prostate cancers. About 186,000 American men are diagnosed with prostate cancer each year.
Researchers studied the data of 3,875 men who were diagnosed with localized prostate cancer, between 1995 and 2008 and noted that doctors improperly staged the cancer 35 per cent of the time.
“There appear to be several problems with our current clinical staging criteria for prostate cancer,” explains study researcher Adam Reese, MD, chief urology resident at the University of California, San Francisco.
He noted that there are several other variables, including prostate-specific antigen (PSA) levels and the tumor’s Gleason score, available for the purpose of diagnosis.
“These variables seem to be more powerful predictors of recurrence than clinical stage,” Reese says.
“We don’t have a good way of staging localized prostate cancer,” says Reza Ghavamian, MD, director of the prostate cancer program at the Montefiore-Einstein Center for Cancer Care and director of urologic oncology and robotic urology at Montefiore Medical Center in New York. Clinical stage is still important for prostate cancers that have spread outside of the prostate gland, he added.
“Ultrasounds are not a very accurate way of visualizing the prostate,” he says. Digital rectal exams (DRE) are also very subjective, he says. American Cancer Society Chief Medical Officer Otis W. Brawley, MD, says it can be hard to determine which localized prostate cancers will recur. The fact remains that most doctors often don’t know how tumors grow.