A new study shows that while prostate-specific antigen (PSA) measurement remains an important monitoring tool, it performs poorly in distinguishing those who will develop lethal prostate cancer from those at low or no risk of disease progression. The results are reported in the April 4 issue of the Journal of the National Cancer Institute, where the authors call for better decision-making tools for active monitoring of patients with early disease.
In the study, part of the Scandinavian Prostate Cancer Group research, physicians analyzed the rate of change of PSA levels in 267 men from Sweden, Finland, and Iceland who were diagnosed with early localized prostate cancer. The researchers recorded the PSA levels for the first 2 years after diagnosis to capture the patients’ early PSA patterns. The men in the study received no curative treatment for the first 2 years but were closely watched for signs of progression.
At the end of follow-up, 34 (13%) patients died from prostate cancer and 18 (7%) developed metastatic prostate cancer. Although initial PSA values and the rate of change were associated with later development of lethal prostate cancer, they were not accurate enough to predict lethal cancer.