Speed of PSA rise helps predict survival for prostate cancer patients

October 03, 2005

The clinical outcome for prostate cancer patients who have been treated with hormone therapy and radiation therapy can usually be determined by how rapidly their prostate specific antigen level rises following treatment, according to a report published in the October 1, 2005 issue of the International Journal of Radiation OncologyBiologyPhysics, the official journal of ASTRO.

Doctors at M.D. Anderson Cancer Center in Houston studied 621 men with prostate cancer treated with hormone and radiation therapy between 1989 and 2003 to determine whether clinical failure after their treatment correlated with the speed at which their post treatment PSA level rose. Clinical failure was defined as cancer recurring in the prostate or spreading to other parts of the body.

Researchers found that measuring how quickly the PSA level doubled was a good indicator of subsequent poor clinical outcomes, including cancer developing in other parts of the body or death related to prostate cancer.

Patients whose PSA level doubled within eight months after treatment failure were more likely to have the cancer return or spread to other parts of the body than patients whose PSA did not double in eight months or less. The estimated five-year rate of clinical failure for patients with a PSA doubling time of more than eight months was only 9.4 percent while 60.4 percent of patients whose PSA doubling time was less than or equal to eight months could expect some type of clinical failure.

"The PSA doubling time is an important indicator of how well a patient will recover from prostate cancer," said Andrew K. Lee, M.D., lead author of the study and a radiation oncologist at M.D. Anderson Cancer Center in Houston. "Although clinical outcomes may be positively affected if the patient receives hormone therapy with radiation therapy, a quickly rising PSA level unfortunately still portends poor results for these patients."

American Society for Therapeutic Radiology and Onc

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