How to tell when localized cancer is advancing

Nancy Ferrari

Senior editor, Harvard Health

Repeat prostate biopsies can help detect disease progression in men diagnosed with early-stage prostate cancer pursuing active surveillance. But whether repeat biopsies are really needed — and if so, when they should be done — are unanswered questions. To add to the debate, British researchers studied 119 men with untreated disease who had a biopsy to diagnose the condition and a follow-up biopsy 18 to 24 months later. Among the 28% of patients whose disease advanced, two histological factors proved key predictors of cancer progression: PSA density of 0.2 ng/ml/ml or greater (PSA density is the PSA level in the blood divided by the volume of the prostate), and any tissue sample considered 15% cancerous or more. As a result, the researchers conclude that a repeat biopsy should be an integral part of active surveillance for untreated, localized prostate cancer. They also recommend considering an immediate repeat biopsy for patients with a PSA density greater than 0.2 ng/ml/ml.

Source: Venkitaraman R, Norman A, Woode-Amissah R, et al. Predictors of Histological Disease Progression in Untreated, Localized Prostate Cancer. Journal of Urology 2007;178:833–37. PMID: 17631355.

Originally published April 2009;  last reviewed March 2, 2011.

Comments:

  1. gary warren

    how do I get someone to look at my pathology report

  2. Catarina

    Just yesterday, I leanred of the passing of an old high school friend. He was a couple of years ahead of me. But we lived about 7 houses from each other for about 15 years. Unfortunately, he died from prostate cancer. Is this the devil’s way of sewing seeds of doubt and fear in my mind? I believe so. Shook me up quite a bit last night. But today is a new day. A new opportunity to be thankful. Maybe even pause to think and smile.

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