Prostate Cancer Progression May Still Occur With Low PSA Levels
Prostate cancer progression may still occur with low PSA levels
US researchers have warned that prostate cancer progression can still occur in men who have undetectable or low prostate-specific antigen (PSA) levels.
PSA is a protein produced by the prostate gland. A blood test that measures levels of this protein is used to indicate prostate cancer development or progression in men.
Writing in the journal Cancer, Dr Dan Leibovici, from the University of Texas MD Anderson Cancer Center in Houston, and colleagues explain: “Because of the very high negative predictive value of an undetectable PSA level after radical prostatectomy [prostate cancer surgery], such patients usually are considered disease free.”
However, they add that at their centre they “have observed a number of patients with prostate cancer who experienced disease progression despite a low or undetectable PSA serum [blood] level”.
Dr Leibovici and team explain that 46 patients treated for prostate cancer between 1999 and 2004 experienced disease progression in the presence of a PSA level of no more than 2 ng/ml, which is considered normal.
These men represented 1.1% of all those who presented with prostate cancer during the period studied.
Indeed, 10 (22%) of the 46 patients developed cancer spread (metastasis) in the presence of an undetectable PSA level.
The researchers advise that, because most of these men showed no symptoms of the disease, careful surveillance should be considered for men with low levels of PSA who have previously been treated for prostate cancer, particularly those who have been treated for an aggressive form of the disease.
They conclude: “Progression of prostate cancer may occur despite undetectable or low PSA levels. Complete physical evaluation and imaging studies may be indicated in the surveillance of patients with high-grade, locally advanced tumours.”
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