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Page 1 of 2  Also: Can a prostate cancer diagnosis give you a heart attack?
For us prostate cancer patients and survivors, we know the importance of the PSA blood test. For me, the simple test caught my prostate cancer very early, probably years before a doctor could have felt it via digital rectal exam.
Now, American and Swiss researchers say the PSA test before age 50 can help tell which men might develop aggressive prostate cancer, even 25 years down the road.
A higher PSA when a man is young makes him more likely to get the slow-growing cancer, which in turn has more time to spread to other parts of the body, said Andrew Vickers, a cancer specialist at New York City’s Memorial Sloan-Kettering Cancer Center who helped with the study. The project also involved researchers from Sweden’s Lund University.
"This suggests the possibility of using an early PSA test, so that men at highest risk are the focus of the most intensive screening efforts,” the researchers say, in the latest BMC Medicine.
The higher the PSA . . . The PSA blood test measures the amount of “prostate specific antigen” in the blood. Prostate infections, inflammation, enlargement or cancer will cause a man’s PSA readings to rise. Only a biopsy can spot cancer, but generally speaking, the higher the PSA reading and the faster the increase from one test to the next raise a man’s risk of prostate cancer.
In previous studies, the Sloan-Kettering researchers showed that the PSA test could predict prostate cancer in men up to 25 years before diagnosis. Their latest findings say that men in their study who had the highest PSA years before being diagnosed with prostate cancer had a 12-percent higher chance of eventually having aggressive cancer than men with lower PSAs. The researchers, however, echo criticisms of the PSA test. They note that because many prostate tumors don’t cause serious symptoms or even death, current screening guidelines may cause doctors to overdiagnose and overtreat the disease. Current U.S. prostate screening guidelines recommend that all men over 50 with a life expectancy of at least 10 years, should have an annual digital examination and PSA test.
"A screening program that focused on those at highest risk of prostate cancer morbidity or mortality might well have a superior benefit-to-harm ratio compared with the current approach of screening all men," the researchers say. Biopsies and heart attacks
In another news on the prostate cancer front: Heart attacks? Stress and anxiety after receiving a diagnosis of prostate cancer may trigger adverse heart reactions. In fact, men suffered a 50-percent higher risk of fatal heart attacks and a 30-percent greater risk of a non-fatal problem in the year after the doctor told them “You have prostate cancer.”
Such heart problems were most likely in the first week after diagnosis, in younger men and men without cardiovascular risk factors, says Dr. Fang Fang, a researcher at the Karolinska Institutet in Stockholm, Sweden.
Dr. Bruce J. Roth, a specialist at the Vanderbilt-Ingram Cancer Center in Nashville, Tenn., says he’s not surprised by the findings because of well-established links between emotional stress and heart problems. But such stress and heart problems are probably apparent when people are diagnosed with any kind of cancer, he adds.
Roth recommends that men and their doctors talk about the implications of a PSA blood test before even the first drop of blood is drawn. Waiting until after the test come back positive for cancer will lower the boom on a man.
The Swedish study found that out of nearly 150,000 men with prostate cancer, more than 5,400 wound up with non-fatal heart problems and more than 2,600 died from heart problems during the first year after they were diagnosed with cancer. Men younger than 55 when they were diagnosed were almost nine times more likely to have fatal heart problems, according to the researchers.
Biopsy tell-more. A biopsy may reveal more important information about a man’s prostate cancer than originally thought, a finding that may help doctors tailor radiation treatments, specialists at Philly's Fox Chase Cancer Center report.
External and internal radiation “offers the chance of a cure for most patients," says Dr. Mark K. Buyyounouski, a center radiation oncologist. "For some, however, an elevated PSA level after treatment indicates the cancer is still around or has come back. Our new study shows how we can use biopsy information prior to treatment to help us predict which patients are most likely to still have disease after treatment. With this knowledge, we can better tailor treatment."
In his study, Buyyounouski found that larger tumors are probably more likely to persist after radiation treatment. In fact, a high percentage of cancer observed in the biopsy taken before treatment correlated with a higher probability of a positive biopsy after treatment, he adds.
"This study is important because the percentage of cancer seen in the biopsy before treatment is directly correlated with cancer seen in the biopsy in the same location two years after treatment," Buyyounouski says. "We believe this study will help raise awareness about which patients may be at greatest risk of having persistent prostate cancer and help us improve future treatment.
"Our next step in this area of research is to see if we can prevent recurrence by delivering more radiation to the area of the prostate with the greatest amount of cancer."
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