Scientists may have discovered a way to predict whether prostate cancer in any particular patient will be fast-growing or slow-growing, enabling doctors to make more appropriate treatment recommendations.
Today, physicians have effective means of diagnosing prostate cancer, but there is great debate about which treatment is best for a cancer diagnosed in the early stages. The options are to do nothing, to have the cancer surgically removed or to begin radiation therapy.Each treatment has advantages and disadvantages. Radiation and surgery can result in complications, including impotence and incontinence. To simply monitor the disease without treating it means living with cancer and possibly missing an opportunity for a cure.
A new discovery by researchers at the National Institute on Aging (NIA) and colleagues at the Johns Hopkins University School of Medicine suggests that the ratio of free to total prostate-specific antigen (PSA) in a man's blood may predict at the time of diagnosis whether prostate cancer will be aggressive or nonaggressive.
"The ability to differentiate between an aggressive and nonaggressive form of prostate cancer when the disease is diagnosed early puts the physician and patient in a better position to make decisions about treatment," said Dr. E. Jeffrey Metter, medical officer for the Baltimore Longitudinal Study of Aging and one of the study's authors.
"Physicians need a reliable way of distinguishing which cancers are serious, life-threatening tumors and which ones are not," Metter said. "The ratio of free to total PSA may give physicians this information."
The results of the study appear in the March 1997 issue of the journal Urology.