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VA RESEARCH IDENTIFIES WHICH MEN NEED A SECOND
PROSTATE BIOPSY -- "We have derived a simple
marker
so urologists can identify who is at risk for
high-grade prostate cancer."
Story here...
http://www.eurekalert.
org/pub_releases/2007-
06/ohs-oci053007.php
Story below:
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Contact: Christine Decker
deckerch@ohsu.edu
503-494-8231
Oregon Health & Science University
OHSU Cancer Institute, VA researchers find way
to identify which men need a second biopsy
PORTLAND, Ore. — A researcher in the Oregon Health & Science University
Cancer Institute and Portland Veterans Affairs Medical Center has found
a way to identify which men need a second prostate biopsy because they
may be harboring life-threatening prostate cancer even though they were
given a clean bill of health after their first biopsy.
Shane Rogosin, M.D., principal investigator, resident, in general
internal medicine, OHSU School of Medicine, will present the research on
Saturday, June 2 at 1:45 p.m. CDT at the 43rd annual meeting of the
American Society of Clinical Oncologists in Chicago.
Also involved in the research is Mark Garzotto, M.D., h the director of
urologic oncology at the Portland Veterans Affairs Medical Center,
assistant professor of surgery (urology) in the OHSU School of Medicine,
and member of the OHSU Cancer Institute.
"Until now we've really had no clear and consistent method to recommend
further follow up or diagnostic procedures for men who have a negative
biopsy. We have derived a simple marker so urologists can identify who
is at risk for high-grade prostate cancer," Garzotto said.
Rogosin studied what is considered a large group, 511 subjects at the
Portland Veterans Affairs Medical Center from 1992 to 2006. All had been
referred to urology clinics for suspicion of prostate cancer. All
patients had one prior negative prostate biopsy. In all, the study
included 1,319 biopsies.
What the researchers found to be the indicator for a repeat biopsy was a
high prostate specific antigen (PSA) adjusted for prostate size. A
Gleason score of 7 or above was indicative that life-threatening
prostate cancer may be present and a repeat biopsy is advised.
A Gleason score is a system of grading prostate cancer tissue based on
how it looks under a microscope. Gleason scores range from 2 to 10 and
indicate how likely it is that a tumor will spread. A low Gleason score
means the cancer tissue is similar to normal prostate tissue and the
cancer is less likely to spread; a high Gleason score means the cancer
tissue is very different from normal tissue and the tumor is more likely
to spread. A high grade of cancer results in a higher PSA. Garzotto also
stresses the size of the prostate has to be taken into account when
measuring PSA.
"What we worry about is which men may have high-grade cancer. Now we can
prescribe a second biopsy for a few months later. We know that this is a
judicious use for a biopsy," Garzotto said. Besides identifying which
men may have a deadly form of prostate cancer this new finding could
also reduce the rate of overtreatment, unnecessary biopsies and
overdiagnosis.
Prostate biopsies can cause patient anxiety, pain, bleeding and
infection, and can lead to a significant increase in medical and
non-medical costs to health care systems and patients.
This study is particularly meaningful because of the large sample size
of patient cases, and it is longitudinal, which means researchers were
able to study the patients for many years.
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Prostate cancer is the most common cancer, excluding skin cancer, and
the second leading cause of cancer-related death in men in the United
States. It is estimated that there will be 218,890 new cases diagnosed
in 2007, and 27,050 men will die from prostate cancer this year in the
United States.
More than 1 million prostate biopsies are performed each year. Of those,
only about 25 percent test positive for cancer. However, another 25
percent are given a false negative, meaning that no cancer is detected
even when later it is found that the patient does have cancer.
The OHSU Cancer Institute is the only cancer center designated by the
National Cancer Institute center between Sacramento and Seattle. It
comprises some 120 clinical researchers, basic scientists and population
scientists who work together to translate scientific discoveries into
longer and better lives for Oregon's cancer patients. In the lab, basic
scientists examine cancer cells and normal cells to uncover molecular
abnormalities that cause the disease. This basic science informs more
than 200 clinical trials conducted at the OHSU Cancer Institute.
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Larry Scott --
