How to tell when localized cancer is advancing

Charlie Schmidt

Editor, Harvard Medical School Annual Report on Prostate Diseases

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.


  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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