New way to use PSA test might identify men who need aggressive prostate cancer treatment

In the journals

Prostate-specific antigen (PSA) tests are used to help identify men who may have a higher risk of prostate cancer. But a study published online Jan. 12, 2017, by JAMA Oncology, describes a new way to use PSA that may pinpoint men who are likely to die early from prostate cancer that returns after initial treatment.

The researchers used data from a randomized trial of 157 men whose localized cancer was treated with either radiation alone or radiation along with six months of androgen deprivation therapy. The men were then followed for 16 years.

The data showed that a PSA nadir — the lowest level a PSA reading drops after treatment — greater than 0.5 ng/ml appears to identify men who are at high risk for dying early as a result of their initial treatment failing.

Two-thirds of all prostate cancer deaths in the United States occur in men with localized cancer that later spreads to other places in the body. This way of using PSA can help doctors know which men might benefit from more aggressive secondary treatment and help them get that treatment earlier, says lead researcher Dr. Anthony D'Amico of Harvard-affiliated Brigham and Women's Hospital.