More thorough measures are needed when it comes to diagnosing prostate cancer in men considering that most--even those whose cancer is identified as low-risk--receive highly aggressive and sometimes unnecessary treatments, a report published in the Archives of Internal Medicine this week concludes.
Out of 124,000 men diagnosed with the disease between 2004 and 2006, 14 percent had a prostate-specific antigen (PSA) level of less than 4 nanograms per milliliter, which is generally--but not always--considered to be "low risk." Overall, 54 percent of those men were confirmed as being low risk.
Out of that 54 percent, more than three-fourths still underwent an aggressive treatment--such as a removal of the entire prostate or radiation therapy.
"These results underscore the fact that PSA level ... is not a sufficient basis for treatment decisions," the study's authors wrote. According to a WebMD Health News article, the authors want to see "specific genetic signatures" also used as biomarkers for prediction of the disease's aggressiveness.
Drs. Richard Hoffman, of the University of New Mexico School of Medicine, and Stephen Zeliadt, of the University of Washington's Department of Health Services, agree in a complementary commentary in the Archives, calling overdiagnosis and overtreatment "an important legacy of the PSA era."
"The initial promise of PSA screening was that a simple, accurate blood test would save lives by detecting tumors at an early enough stage to be cured by aggressive treatment," Hoffman and Zeliadt wrote. "Unfortunately, some two decades into the PSA era, the promise of early detection has been tarnished."
Hoffman and Zeliadt discuss a newer option in their piece known as active surveillance, according to WebMD. Rather than undergoing aggressive treatment right off the bat, those diagnosed would be carefully monitored through the use of multiple and frequent PSA and DRE (digital rectal exam) tests, combined with more spaced out biopsies.
To learn more:
- read this WebMD Health News article
- here's the report's abstract
- here's the commentary's abstract