PSA « THE "NEW" PROSTATE CANCER INFOLINK

Who needs aggressive treatment after initial radiation … and who does not?

Posted on November 24, 2011 by Sitemaster

A new report in Lancet Oncology offers guidance on which patients with prostate cancer who are initially treated with radiotherapy and 6 months of neoadjuvant androgen deprivation therapy (ADT) are at relatively high and relatively low levels of risk for prostate cancer-specific mortality.

Filed under: Diagnosis, Living with Prostate Cancer, Management, Risk, Treatment | Tagged: ADT, androgen deprivation, cancer-specific, marker, mortality, neoadjuvant, progression, PSA, radiation, surrogate | 2 Comments »

A multi-specialty review of current evidence regarding prostate cancer screening

Posted on November 14, 2011 by Sitemaster

The October issue of the Canadian Journal of Urology contains an interesting and thorough review of the available data on the value of screening for prostate cancer as seen by a group including urologists, urologic oncologists, medical oncologists, radiation oncologists, and a highly regarded primary care physician.

Filed under: Diagnosis, Risk | Tagged: mortality, PSA, risk, screening, testing | Leave a Comment »

Prostate cancer screening (in Germany): curative or harmful?

Posted on November 14, 2011 by Sitemaster

The debate over the merits and risks of widespread screening for prostate cancer using the PSA test is hardly confined to the USA. A new article (in German) in the journal Urologie A addresses exactly the same issues as have recently received so much attention here in the States.

Filed under: Diagnosis, Risk | Tagged: Diagnosis, mortality, PSA, risk, screening | 1 Comment »

Beware over-reaction to ultrasensitive PSA doubling times

Posted on November 11, 2011 by Sitemaster

It is not exactly “new” news that PSA doubling times calculated using low levels of ultrasensitive PSA data can be very different to those calulated using standard PSA values. However, a new paper has provided some additional data on this issue.

Filed under: Living with Prostate Cancer, Management | Tagged: doubling time, PSA, standard, ultasensitive | 3 Comments »

AUA issues full, formal comments on USPSTF draft recommendation

Posted on November 10, 2011 by Sitemaster

On November 8, the American Urological Asociation (AUA) issued its full, formal comment letter on the US Preventive Services Task Force (USPSTF)’s draft recommendation of a “D” grade for the use of PSA screening in healthy men with no symptoms of prostate cancer. The AUA also issued a formal statement for the media.

Filed under: Diagnosis, Risk | Tagged: AUA, Diagnosis, PSA, risk, screening, USPSTF | 3 Comments »

Are changes in PSA kinetics potentially indicative of metastasis-free survival?

Posted on October 27, 2011 by Sitemaster

Researchers at Johns Hopkins have provided data to support the hypothesis that, in men being treated with novel, non-hormonal agents for non-metastatic, non-castrate, biochemically recurrent prostate cancer after first-line therapy, changes in PSA kinetics may be indicative of metastasis-free survival.

Filed under: Drugs in development, Management, Treatment | Tagged: endpoint, kinetics, metastasis-free, PSA, survival | Leave a Comment »

PSA screening today: four points of view in the NEJM

Posted on October 26, 2011 by Sitemaster

This week’s issue issue of the New England Journal of Medicine includes four perspective articles on the recent draft recommendation about PSA screening issued by the U.S. Preventive Services Task Force (USPSTF).

Filed under: Diagnosis, Risk | Tagged: PSA, recommendation, screening, testing, USPSTF | 5 Comments »

What happens next after a baseline PSA test?

Posted on October 26, 2011 by Sitemaster

According to data from a prospective study of prostate cancer outcomes conducted by researchers at the Mayo Clinic, the PSA test is “valuable in predicting which men should have biopsies and which are likely to be diagnosed with low-risk prostate cancer.”

Filed under: Diagnosis, Management, Risk | Tagged: benefit, biopsy, PSA, risk | 3 Comments »

Another investigational test may refine data on need for prostate biopsy

Posted on October 23, 2011 by Sitemaster

A newly published paper in the Journal of Urology describes a multi-center, prospective study of the potential of the investigational, urine-based, ProCaM™ assay as a test to offer improved evaluation of the need for prostate biopsy among men with an initial total serum PSA level between 2 and 10 ng/ml.

Filed under: Diagnosis, Risk | Tagged: biopsy, Diagnosis, epigenetic, ProCaM, PSA, risk, test | 7 Comments »

Can Sebelius actually NOT cover the costs of PSA testing for Medicare patients?

Posted on October 18, 2011 by Sitemaster

A key concern associated with the USPSTF recommendation that widespread “screening” of uninformed men be eliminated is that this recommendation would lead to non-coverage of PSA testing in otherwise healthy men.

Filed under: Diagnosis, Living with Prostate Cancer, Management, Risk, Treatment | Tagged: cost, coverage, Diagnosis, PPACA, PSA, risk, Social Security Act, USPSTF | 37 Comments »

Another, separate look at the value of mass, PSA-based screening

Posted on October 17, 2011 by Sitemaster

For those who are really “into” the probabilistic statistics of prostate cancer decision analysis, we recommend a recent article in the journal Medical Decision-Making.

Filed under: Diagnosis, Risk | Tagged: analysis, decision, Markov, model, PSA, screening | 7 Comments »

Another eminent urologic oncologist on the USPSTF recommendation

Posted on October 16, 2011 by Sitemaster

The following editorial commentary related to the USPSTF recommendation was published on Friday, October 13, 2011 on the UroToday web site and is reproduced here with the permission of UroToday. The commentary was written by Alan Wein, MD,

Filed under: Diagnosis, Living with Prostate Cancer, Management, Risk | Tagged: PSA, recommendation, risk, screening, testing, USPSTF | 6 Comments »

Opinions on the USPSTF recommendation are all over the map — and all “off the money”

Posted on October 14, 2011 by Sitemaster

As one might expect, there is an extremely diverse (and conflicting) range of reactions to the USPSTF recommendation that routine PSA testing of uninformed men is not supported by good evidence and should no longer be considered as appropriate “standard” practice unless there has been a prior discussion of the risks and benefits of the [...]

Filed under: Diagnosis, Management, Risk | Tagged: benefit, cost, coverage, PSA, risk, USPSTF | 6 Comments »

USPSTF and PSA testing in the media

Posted on October 10, 2011 by Sitemaster

The media – over the past few days — has taken every opportunity to “stoke the furore” about the USPSTF’s recommendation that PSA screening (of all men aged 50 to 75 years of age, or thereabouts) is not justified by the available data.

Filed under: Diagnosis, Management, Risk | Tagged: PSA, risk, testing, USPSTF | 3 Comments »

Poor science underlies the USPSTF recommendation about PSA-based screening

Posted on October 8, 2011 by Sitemaster

Whatever we may think individually about the recent decision by the U.S. Preventive Services Task Force to recommend against the use of PSA testing as a means of “screening” for risk of prostate cancer, we would be wise to understand that at the heart of this decision is poor science.

Filed under: Diagnosis, Living with Prostate Cancer, Management, Risk | Tagged: PSA, risk, screening, survival, USPSTF | 29 Comments »

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