Over-reliance on test could result in unnecessary biopsies
SAN ANTONIO (February 24, 2011) – Cancer organizations commonly recommend prostate biopsies for men who have experienced a rapid rise in PSA levels. But according to findings from a San Antonio study that were published online today in the Journal of the National Cancer Institute, that change, called PSA velocity, is not a good predictor of prostate cancer.
Other factors besides PSA velocity should be taken into account when determining a man’s risk of prostate cancer and whether he should have a biopsy, said Ian M. Thompson Jr., M.D., director of The University of Texas Health Science Center at San Antonio’s Cancer Therapy & Research Center.
Andrew Vickers, Ph.D., of Memorial Sloan-Kettering Cancer Center, is lead author of the paper that analyzes data from a study, the Prostate Cancer Prevention Trial, in which Dr. Thompson was principal investigator.
“We previously documented this fact that Dr. Vickers has reinforced,” Dr. Thompson said. “Our conclusions are clear: PSA and other factors including race, age, family history and physical examination findings are what really matter in determining a man’s risk of prostate cancer.”
The paper concludes, “We found no evidence to support the recommendation that men with high PSA velocity should be biopsied in the absence of other indications; this measure should not be included in practice guidelines.”
In an accompanying editorial, Siu-Long Yao, M.D., and Grace Lu-Yao, Ph.D., of the Cancer Institute of New Jersey, say that the results of this study “remind us that the use of PSA as a screening tool still leaves much to be desired.”
The CTRC prostate cancer team recommends the use of the Risk Calculator, which combines this information in a way that a man and his physician can understand. “The Risk Calculator, now used more than 55,000 times for this purpose, can be found at www.prostate-cancer-risk-calculator.org,” Dr. Thompson said.
The Cancer Therapy & Research Center (CTRC) at The University of Texas Health Science Center at San Antonio is one of the elite academic cancer centers in the country to be named a National Cancer Institute (NCI) Designated Cancer Center, and is one of only four in Texas. A leader in developing new drugs to treat cancer, the CTRC Institute for Drug Development (IDD) conducts one of the largest oncology Phase I clinical drug programs in the world, and participates in development of cancer drugs approved by the U.S. Food & Drug Administration. For more information, visit www.ctrc.net.