The Saturday news report: March 14, 2009

Reports presented this morning address:

  • Diet and risk for prostate cancer among Jamaican males
  • Diagnostic markers and low risk prostate cancer
  • PSA-expression in cells from bone marrow aspirates and bone marrow biopsy specimens

Jackson et al. have studied  the association between dietary patterns and risk of prostate cancer in Jamaican men by conducting a case-control study of the diets of 204 histologically confirmed, newly diagnosed prostate cancer patients and 204 matched control patients attending urology clinics in Jamaica between2004 and 2007. Diet was assessed by food frequency questionnaire. Diets were categorized into four different groups, but the authors were unable to show any significant impact of a specific diet on risk for prostate cancer in this patient population in this study.

Schröder has reviewed currently available data on diagnostic markers for relatively low risk prostate cancer. He argues that we need a better understanding of the natural history of cases with low PSA values that would not be considered suspicious with the use of currently available risk indicator nomograms. He further suggests that data from the European Randomised Study of Screening for Prostate Cancer (ERSPC) offers such an opportunity. He proposes that there is now evidence that men diagnosed in the low PSA ranges (< 3.0 ng/ml) usually present with more favorable cancers which, when identified, are often eligible for active surveillance after application of the appropriate nomogram. He also states that data from the ERSPC study show that biopsies in such men can safely be delayed until their PSA rises to above a cut-off value of 3.0 ng/ml.

Murray et al. have carried out a prospective study to determine the presence of cells that express PSA in aspirates taken from bone marrow and to compare the presence of PSA-expressing cells in the aspirates with bone marrow biopsy samples from prostate cancer patients. Results indicated a highly significant difference between the frequency of cells detected in bone marrow aspirate and in biopsy samples. There was no difference between the frequencies of cells detected in bone marrow aspirate and biopsy of patients analyzed before treatment. However, there was a significant difference between them after treatment. There was also a significant difference in the frequency of PSA-positive cells detected when classified by clinical stage or by Gleason score. The authors claim that these results explain the lack of correlation between positive aspirates and prognosis in numerous clinical cases.

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