THE "NEW" PROSTATE CANCER INFOLINK

Today’s news reports address:

• Additional new markers associated with prostate cancer risk
• Relationships between age, total PSA level, and percentage free/total PSA in a cohort of screened patients
• Are African-Americans at higher risk for positive surgical margins?
• High-dose brachytherapy after abdominoperineal resection and pelvic external beam radiation

Singh et al. have shown that there seems to be an association between the levels of two cytokines (CXCL13 and CXCL5), interleukin-6 (IL-6), and PSA — at least in the blood sera from patients diagnosed with prostate cancer. Whether these data have any real, clinical significance has still to be established.

Capitanio et al. have examined total PSA and the percentage of free/total PSA values in 3,222 patients undergoing prostate cancer screening in Canada. They showed a clear relationship between the total PSA level, the percentage free/total PSA, and patient age. The authors suggest that the data from thie study may be helpful in guiding clinicians regarding the population-based distribution of serum total PSA and percentage free/total PSA values, and that those values can be used for the purpose of counseling, as well as in the informed consent process before prostate biopsy.

Rabbani et al. have tried to assess whether the rate of positive surgical margins (PSMs) — and  apical PSMs in particular — after radical prostatectomy (RP) for prostate cancer is higher in African-Americans than Caucasian men, given their often narrower and deeper pelvis. They analyzed data (collected between 1999 and 2007) from 3,145 consecutive patients who received a radical prostatectomy from one of five surgeons. Their results suggested that ethnicity was not a significant independent predictor of overall PSMs or PSMs at most specific sites (bladder neck, posteriorly, or anteriorly). There was a marginally significant difference in risk for apical PSMs, however, with African-Americans having a slightly greater risk than Caucasians, independent of pathological organ-confined status and PSA level.

Jabbari et al. suggest that, based on their experience in a small number of patients, transperineal ultrasound-guided high-dose brachytherapy should be considered as definitive therapy for patients with localized prostate cancer and a prior history of either abdominoperineal resection and pelvic external beam radiation.

Filed under: Diagnosis, Living with Prostate Cancer, Management, Risk, Treatment