Tuesday’s prostate cancer news: October 14, 2008

In today’s update there is information about:

  • Excess body mass and risk from prostate cancer death
  • The potential role of the PCA3 test
  • Focal treatment for localized disease using targeted photodynamic therapy

A retrospective study by Ma et al., based on data from 24-year follow-up of the Physicians’ Health Study, suggests that men who have excess pre-diagnostic body weight and/or a high plasma C-peptide level (reflective of high levels of insulin secretion) are at significantly greater risk for death from prostate cancer than men with healthy body weights and low C-peptide levels. It would appear that an excessive body mass and high C-protein levels may predispose men to greater risk of death from prostate cancer if they are diagnosed with this disease.

Marks and Bostwick have reviewed the overall potential of the prostate cancer 3 (PCA3) gene test in the diagnosis of prostate cancer. They suggest that, compared to the PSA test, the gene test offers great promise. In particular, they state that PCA3 gene testing holds valuable potential in PSA difficult situations such as the following: (1) men with elevated PSA levels but no cancer on initial biopsy; (2) men found to have cancer despite normal levels of PSA; (3) men with PSA elevations associated with varying degrees of prostatitis; and (4) men undergoing active surveillance for presumed microfocal disease.

A paper presented by Haese and colleagues at the 60th annual congress of the German Urological Association has suggested the potential of PCA3 as a tool to determine which patients may need re-biopsy following one or two prior negative biopsies. However the results of this study are not conclusive, and th authors conclude only that their results using PCA3 “improve the ability to indicate” the need fo a re-biopsy in cases of negative previous biopsy(ies). ”

Eggener and Coleman have reviewed available data on the potential of “vascular-targeted photodynamic therapy” as a potential form of treatment that is being evaluated in for focal therapy of localized prostate cancer (i.e., a form of treatment that is directed solely at the focus of cancer within the prostate rather than the entire prostate).

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