Analysis of 1,700 Patients Connects PSA Testing with Lower Risk of Developing Advanced Disease
Cleveland Clinic researchers today announced the results of a study that suggests prostate cancer screening improves quality of life and decreases a patient’s risk of developing metastatic disease. Patients treated before routine prostate-specific antigen (PSA) screening was advocated had a 10-year metastases-free survival of 74% versus 91% for those treated after routine PSA screening was advocated. Chandana Reddy, biostatistician and lead author, will present this research Nov. 1 at the 52nd Annual Meeting of the American Society for Radiation Oncology (ASTRO) in San Diego.
The study shows that patients treated in the era before prostate cancer screening with PSA testing was commonplace, were significantly more likely to develop metastatic disease within 10 years of treatment compared to men in the post-screening era.
The impact of screening for prostate cancer has been widely debated and in 1993, the use of PSA testing was first advocated in the U.S. Opponents of routine screening have argued that it has not resulted in a meaningful improvement in survival. In this particular study, researchers determined that the best way to evaluate the effectiveness of screening was to examine its ability to decrease the development of metastatic prostate cancer within 10 years after treatment.
“The study shows that routine screening not only improves the patient’s quality of life by reducing the risk of developing metastatic disease, but it decreases side effects and complications associated with the advanced disease as well,” said Reddy.
The study was based on data from over 1,700 prostate cancer patients who were treated at Cleveland Clinic with either radiation therapy or surgery to remove the prostate gland and surrounding tissues. To assess the impact of screening, the patients were divided into two groups according to when they were treated: a pre-screening era (1986-1992) or a post-screening era (1993-1996). Patients were classified as having high, intermediate, or low-risk disease to determine which groups may have benefited from prostate cancer screening.
Prostate cancer is the most common cancer in men, and the second leading cause of cancer death among men in the United States. Cleveland Clinic will be showcasing other significant prostate cancer research results at the ASTRO Annual Meeting, including:
- “Identification of an Unfavorable Subgroup of High-risk, Localized Prostate Cancer Treated with External Beam Radiation.” Research by Dr. Rahul Tendulkar and his team suggests that we may need to use more aggressive therapy for these “unfavorable” high risk prostate cancer patients.
- “Long-Term Outcome of 2040 Patients Treated with I-125 Prostate Brachytherapy.” Dr. Mohammad Khan and other investigators conclude that prostate brachytherapy provides excellent rates of biochemical control, distant metastases control, and prevents patients from dying of metastatic disease across all risk groups.
- “Long Term vs. Short Term Androgen Deprivation Therapy in Patients Treated with External Beam Radiotherapy for High Risk Prostate Cancer in the PSA era.” Dr. Andrew Vassil and his team studied results from 507 men treated with elevated radiation doses to determine if the duration of testosterone suppression could be reduced. The study found that from a prostate cancer control standpoint, it appears that suppressing testosterone for more then six months may not be necessary for men treated with higher doses of radiation therapy.
- “Long-Term Toxicity after Treatment for Prostate Cancer with External Beam Radiation Therapy, Interstitial Brachytherapy, or Radical Prostatectomy.”Dr. Grant Hunter and his research team present a study of patients treated for localized prostate cancer from the year 1999, with prostate brachytherapy, radical prostatectomy or external beam radiation therapy. The goal of the project was to examine potential long term toxicity profiles for all patients with a potential of 10 year follow-up.
About Cleveland Clinic
Cleveland Clinic, located in Cleveland, Ohio, is a not-for-profit multispecialty academic medical center that integrates clinical and hospital care with research and education. It was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. About 2,100 full-time salaried physicians and researchers and 11,000 nurses represent 120 medical specialties and subspecialties. In addition to its main campus, Cleveland Clinic operates nine community hospitals and 15 Family Health Centers in Northeast Ohio, Cleveland Clinic Florida, the Lou Ruvo Center for Brain Health in Las Vegas, Cleveland Clinic Canada, and opening in 2012, Cleveland Clinic Abu Dhabi. In 2009, there were more than 4.6 million visits throughout the Cleveland Clinic health system and 170,000 hospital admissions. Patients came for treatment from every state and from more than 100 countries.
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