Factors in mortality after prostate cancer recurrence

Reported by Susan Aldridge, PhD, medical journalist

A combination of three risk factors gives doctors a good idea of the lethality of prostate cancer after recurrence.
Some patients live for many years after the recurrence of prostate cancer while, in others, the disease progresses rapidly. The former group may need nothing more than monitoring while the latter could benefit from further treatment. To try to pinpoint who is most at risk of recurrence, doctors at Johns Hopkins Medical School studied a group of nearly 400 patients who had had prostate cancer surgery between 1982 and 2000 and went on to experience a recurrence of their disease.

The study uncovered three risk factors. First, the time from surgery to a doubling of the prostate specific antigen (PSA) level was important - the shorter the time, the greater the risk. Second, the time from surgery to recurrence as measured by PSA level was important. The shorter this time, the greater the risk. Finally, the Gleason score was a factor. This is a number from 2 to 10 which is derived from microscopic examination of a tumor. The higher the number the greater the risk.

The Hopkins scientists have combined these three factors into a tool which can be used to predict the risk of lethality in recurrence of prostate cancer. Those men who are at high risk can be offered more treatment. Those at low risk can, however, live for up to 16 years and maybe more with just ongoing monitoring.

Source
Journal of the American Medical Association 27th July 2005