SAN DIEGO—Men treated for prostate cancer that was detected as a result of PSA screening may be at lower risk of metastatic disease within 10 years of treatment than men treated for PCa not found by PSA screening, according to researchers.
“Our study shows that routine screening not only improves the patient’s quality of life by stopping metastatic disease, but it also decreases the burden of care for this advanced disease that must be provided by the health care system,” said lead researcher Chandana Reddy, MS, a senior biostatistician at Cleveland Clinic in Ohio. “This demonstrates that the PSA test is extremely valuable in catching the disease earlier and allowing men to live more productive lives after treatment.”
Reddy and her colleagues reviewed data from 1,721 PCa patients treated with either radiation or radical prostatectomy at Cleveland Clinic between 1986 and 1996. Investigators divided patients into two groups according to whether they were treated during the pre-screening era (1986-1992) or the post-screening era (1993-1996). They classified patients as having low-, intermediate-, or high-risk disease to determine which groups may have benefitted from PSA screening.
The pre-screening era group (PRE) included 575 patients and the post-screening group (POST) included 1,146 patients. Due to the potential for an imbalance in follow-up time between the two groups, patients still at risk for recurrence beyond 10 years were censored at 10 years.
Among the PRE patients, 28%, 21%, and 44% had low-, intermediate-, and high-risk disease, respectively, according to findings presented at the 52nd Annual Meeting of the American Society for Radiation Oncology. Among the POST patients, 37%, 27%, and 36% had low-, intermediate-, and high-risk disease. Within 10 years of treatment, metastatic disease had developed in 13% of patients in both groups. Among low-risk patients, the 10-year metastasis-free survival rate was 90% in the PRE group and 98% in the POST group. Among the intermediate-risk patients, the rate was 79% and 93%, respectively. Among the high-risk patients, the rates were 58% and 82%. In multivariate analysis, the PRE patients were 3.5 times as likely to develop metastases than the POST group.
“Metastatic prostate cancer is an incurable condition and it is often treated with long-term hormonal therapy, which has a lot of detrimental side effects which affect a patient’s quality of life, and this includes hot flashes, weight gain, and a loss of libido,” Reddy told Renal & Urology News. “There has also been some recent research showing that long-term hormonal therapy increases a patient’s risk of developing diabetes and cardiovascular disease.”