Recent findings published in the December issue of the Journal of Urology suggest the size of a man’s prostate gland may help predict the severity of cancer.
Vanderbilt-Ingram Cancer Center researchers examined 1251 cases of prostate cancer among men who underwent surgery to remove their prostate between January 2000 and June 2008. Due to a Gleason score of 6 or less and low levels of prostate-specific antigen (PSA), these patients were considered to have low-risk disease. In fact, these patients’ treatment options were potentially less aggressive, such as observation.
Investigators discovered that in 31% of the cases, upon examination of the tissue removed during surgery, the severity of the cancer was upgraded from the presurgery assessment. More specifically, men with smaller prostates were prone to have their cancer upgraded following surgery.
According to Daniel Barocas, MD, MPH, assistant professor of urologic surgery and senior author on the study, “Our field suffers from this great confusion because in half of men you can find prostate cancer in microscopic amounts that may not be clinically significant and yet it’s the second leading cause of cancer death among men. The more you look for it, the more you find it, but that doesn’t help us figure out who needs treatment and who doesn’t.”
Barocas said these recent findings offer one more indication for physicians to take into account when discussing treatment options their patients.
“There’s nothing about size that would necessarily predict a bad outcome. What it’s really about is the ratio of PSA to size, or PSA density, meaning that a small prostate that is making a lot of PSA is likely to be due to a bad tumor, whereas a large prostate making a lot of PSA is likely to be due to benign enlargement of the prostate,” said Barocas.
Source: Vanderbilt University Medical Center.
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