Featured Research

from universities, journals, and other organizations

Low-grade prostate cancers may not become aggressive with time -- adds support for 'watch and wait' approach

Date:
August 14, 2013
Source:
American Association for Cancer Research (AACR)
Summary:
Prostate cancer aggressiveness may be established when the tumor is formed and not alter with time, according to a new study published.

Prostate cancer aggressiveness may be established when the tumor is formed and not alter with time, according to a study published in Cancer Research, a journal of the American Association for Cancer Research.

Researchers found that after the introduction of widespread prostate-specific antigen (PSA) screening, the proportion of patients diagnosed with advanced-stage cancers dropped by more than six-fold in 22 years, but the proportion diagnosed with high Gleason grade cancers did not change substantially. This suggests that low-grade prostate cancers do not progress to higher grade over time.

Cancer stage refers to the extent or spread of the disease, and cancer grade, called Gleason grade for prostate cancer, refers to the aggressiveness of the disease.

"We were able to look at finely stratified time periods to capture pre-PSA, early-PSA, and late-PSA eras within one study. Over time, because of PSA screening, men have been more likely to be diagnosed with prostate cancer at an earlier stage, before the disease has had an opportunity to grow and spread. If Gleason grade also progressed over time, we would expect a similar decrease in high Gleason grade disease over time," said Kathryn Penney, Sc.D., instructor in medicine at the Harvard Medical School and associate epidemiologist at the Channing Division of Network Medicine at Brigham and Women's Hospital in Boston, Mass. "We were surprised by just how constant the incidence of high-grade disease has been over time."

This study adds more evidence to the argument that patients who are diagnosed with low-grade prostate cancers can opt for an active surveillance, or "watch and wait" approach instead of getting treated right away.

Penney and colleagues used data from 420 participants recruited to the Physicians' Health Study and 787 participants recruited to the ongoing Health Professionals Follow-up Study. All participants were diagnosed with prostate cancer between 1982 and 2004, and treated with surgery. The researchers reanalyzed prostate tissue collected from these patients to assess Gleason grade.

The researchers divided the data into four time periods based on when the participants received a diagnosis and treatment: 1982-1993, 1993-1996, 1996-2000, and 2000-2004, to represent the pre-PSA and PSA eras. They found that the number of participants who had undergone PSA screening increased from 42 percent in 1994 to 81 percent in 2000.

They also found that the number of late-stage cancers decreased from 19.9 percent in the 1982-1993 group to just 3 percent in the 2000-2004 group, reflecting an 85 percent drop in stage at diagnosis. However, there was only a moderate decrease in high Gleason grade cancers, from 25.3 percent in the 1982-1993 group to 17.6 percent in the 2000-2004 group, reflecting a 30 percent drop.

With further analyses, the researchers found that the moderate drop in high Gleason grade cancers was not because progression to more aggressive disease was prevented through screening, but because of an increased diagnosis of low-grade disease that would not have been detected without PSA screening.

"Radical prostatectomy or radiation therapy, the usual treatments for prostate cancer, can have negative side effects such as impotence and incontinence; choosing active surveillance could prevent this decline in quality of life," said Penney. "Men with low-grade disease at diagnosis should seriously consider talking with their doctors about active surveillance."


Story Source:

The above story is based on materials provided by American Association for Cancer Research (AACR). Note: Materials may be edited for content and length.


Journal Reference:

  1. K. L. Penney, M. J. Stampfer, J. L. Jahn, J. A. Sinnott, R. Flavin, J. R. Rider, S. Finn, E. Giovannucci, H. D. Sesso, M. Loda, L. A. Mucci, M. Fiorentino. Gleason Grade Progression Is Uncommon. Cancer Research, 2013; 73 (16): 5163 DOI: 10.1158/0008-5472.CAN-13-0427

Cite This Page:

American Association for Cancer Research (AACR). "Low-grade prostate cancers may not become aggressive with time -- adds support for 'watch and wait' approach." ScienceDaily. ScienceDaily, 14 August 2013. <www.sciencedaily.com/releases/2013/08/130814095644.htm>.
American Association for Cancer Research (AACR). (2013, August 14). Low-grade prostate cancers may not become aggressive with time -- adds support for 'watch and wait' approach. ScienceDaily. Retrieved September 3, 2014 from www.sciencedaily.com/releases/2013/08/130814095644.htm
American Association for Cancer Research (AACR). "Low-grade prostate cancers may not become aggressive with time -- adds support for 'watch and wait' approach." ScienceDaily. www.sciencedaily.com/releases/2013/08/130814095644.htm (accessed September 3, 2014).

Share This



More Health & Medicine News

Wednesday, September 3, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Snack Attack: Study Says Action Movies Make You Snack More

Snack Attack: Study Says Action Movies Make You Snack More

Newsy (Sep. 2, 2014) You're more likely to gain weight while watching action flicks than you are watching other types of programming, says a new study published in JAMA. Video provided by Newsy
Powered by NewsLook.com
U.N. Says Ebola Travel Restrictions Will Cause Food Shortage

U.N. Says Ebola Travel Restrictions Will Cause Food Shortage

Newsy (Sep. 2, 2014) The U.N. says the problem is two-fold — quarantine zones and travel restrictions are limiting the movement of both people and food. Video provided by Newsy
Powered by NewsLook.com
Doctors Fear They're Losing Battle Against Ebola

Doctors Fear They're Losing Battle Against Ebola

AP (Sep. 2, 2014) As a third American missionary is confirmed to have contracted Ebola in Liberia, doctors on the ground in West Africa fear they're losing the battle against the outbreak. (Sept. 2) Video provided by AP
Powered by NewsLook.com
Tech Giants Bet on 3D Headsets for Gaming, Healthcare

Tech Giants Bet on 3D Headsets for Gaming, Healthcare

AFP (Sep. 2, 2014) When Facebook acquired the virtual reality hardware developer Oculus VR in March for $2 billion, CEO Mark Zuckerberg hailed the firm's technology as "a new communication platform." Duration: 02:24 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins