PSA Levels May Not Indicate Prostate Cancer Survival, New Study Finds
A recent study conducted by researchers from the University of California Los Angeles (UCLA) suggests that PSA levels may not be related to overall survival in patients with recurring prostate cancer. Published in the Journal of Clinical Oncology, the study challenges the conventional belief that PSA levels are a reliable indicator of a patient’s long-term survival.
PSA, or prostate-specific antigen, is a protein produced by both normal and cancerous cells in the prostate. It is commonly used as a tool to detect prostate cancer and evaluate its risk. However, the UCLA research team analyzed data from 11 trials involving over 10,000 patients and found no correlation between PSA level recurrence and overall survivability.
Biochemical recurrence refers to the presence of cancer cells after treatment, which can cause an increase in PSA levels. This rise in PSA can suggest that the cancer has not been completely eradicated or has reappeared, even if the patient does not exhibit any symptoms.
Dr. Ruchi Talwar, Urologic Oncology Fellow at Vanderbilt University Medical Center, explains that a patient may have a high PSA blood level indicating the return of prostate cancer, but imaging and scans do not detect any cancer in the body. This discrepancy occurs when the amount of cancer is too small to be detected by current imaging techniques.
The study authors argue that biochemical recurrence should not be the primary focus when developing therapies for prostate cancer. Instead, they suggest that “metastasis-free survival remains an appropriate endpoint for prospective trials related to radiation therapy in localized disease.”
While PSA blood tests remain a useful tool for detecting and monitoring prostate cancer, they may not accurately predict a patient’s overall survival. Dr. Amar Kishan, senior author of the study, believes that PSA surveillance can be important but suggests further research to better understand its utility.
Following treatment for prostate cancer, PSA levels typically decrease significantly. Routine follow-up includes imaging studies, although cancer recurrence may not always be visible on these scans. Therefore, a rise in PSA levels may serve as an early marker of recurrence.
The two primary therapies used after biochemical recurrence are salvage radiation therapy and androgen deprivation therapy. Salvage radiation therapy aims to control localized cancer and delay or prevent metastasis. Androgen deprivation therapy, on the other hand, uses hormonal injections to lower PSA levels. However, the effectiveness of these therapies in improving overall survival is not yet known.
Dr. Talwar advises caution when interpreting PSA levels as they are not a perfect indicator of cancer progression. She recommends further research to better understand the role of PSA surveillance and improve its utilization.
Dr. Rajiv Bahl, an emergency medicine physician and health writer, emphasizes that not all cancer recurrences are lethal. He believes that the information from this study can help design better clinical trials and shed light on outcomes beyond just survivability, such as quality of life.
In conclusion, while PSA levels are valuable in detecting prostate cancer and evaluating its risk, their association with overall survival may not be as strong as previously believed. Further research is needed to fully understand the implications of PSA level recurrence in prostate cancer patients.