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Elevated PSA Link to Higher Recurrence Risk in Intermediate-Risk Prostate Cancer
In this investigation of 108 men with intermediate-risk prostate cancer following HIFU, investigators found that in-field and overall recurrence on 1-year biopsy was 41% and 54%, respectively. Moreover, Gleason grade (GG) 3 or higher was associated with both in-field and overall recurrence on biopsy, while sexual and urinary function scores did…
Risk Groups and Lab Tests to Help Determine Risk from Localized Prostate Cancer
Prostate cancer risk groups. For prostate cancer that has not spread (stage I to III cancers), many doctors now use data about the cancer (such as the T category, initial PSA level, Grade Group, and prostate biopsy results) to place it into a risk group. This risk group can then be used to help determine treatment options. Several expert…
What Is Intermediate Risk Prostate Cancer?
Intermediate risk prostate cancer falls between low risk and high risk prostate cancer in terms of aggressiveness. Favorable intermediate risk cancer has a lower chance of spreading and may need…
References from the third link:
- Goy BW, Yao J. Fifteen-year outcomes of external radiation with or without 6 months of neoadjuvant deprivation therapy for intermediate risk prostate cancer.J Clin Oncol. 2025;43(suppl 5):388. doi:10.1200/JCO.2025.43.5suppl.388
- D’Amico AV, Chen MH, Renshaw AA, et al. Androgen suppression and radiation vs radiation alone for prostate cancer: a randomized trial. JAMA. 2008;299(3):289-295. doi:10.1001/jama.299.3.289
- Jones CU, Hunt D, McGowan DG, et al. Radiotherapy and short-term androgen deprivation for localized prostate cancer. N Engl J Med. 2011;365(2):107-118. doi:10.1056/NEJMoa1012348
- Goy BW, Burchette RJ, Soper MS, Chang T, Cosmatos HA. Ten year treatment outcomes of radical prostatectomy vs external beam radiation therapy vs. brachytherapy for 1,503 patients with intermediate risk prostate cancer. J Clin Oncol.2018;36(suppl 6S):47. doi:10.1200/JCO.2018.36.6suppl.47
Interview: elevated PSA Levels Linked to Higher Recurrence Risk in Intermediate-Risk Prostate Cancer
Table of Contents
Recent studies highlight the complex landscape of intermediate-risk prostate cancer and its treatment challenges. Elevated PSA levels and Gleason Grade have been identified as indicators of recurrence risk. We sit down with renowned prostate cancer specialist Dr. Samuel Johnson to discuss these findings and risk stratification strategies.
Understanding Intermediate-Risk Prostate Cancer
Editor: dr. Johnson, can you briefly explain what intermediate-risk prostate cancer is and how it differs from low and high-risk categories?
Dr. Samuel Johnson: Certainly. Intermediate-risk prostate cancer falls between low-risk and high-risk in terms of aggressiveness. ItS characterized by features such as higher PSA levels, adverse histopathology, and a somewhat higher chance of cancer progression compared to low-risk cases. These factors necessitate more aggressive treatment strategies to manage the disease effectively.
Recurrence Risk in Intermediate-Risk Prostate Cancer
Editor: Could you elaborate on the recent findings regarding PSA levels and recurrence risk in men with intermediate-risk prostate cancer following High-Intensity Focused Ultrasound (HIFU) treatment?
Dr. Samuel Johnson: Of course. A study of 108 men with intermediate-risk prostate cancer following HIFU treatment found that in-field and overall recurrence rates on a 1-year biopsy were 41% and 54%, respectively. Importantly,these recurrence rates were linked to higher Gleason grades,specifically those with a grade of 3 or higher. This underscores the importance of close monitoring and perhaps more intensive follow-up protocols for such patients.
Risk Stratification and lab Tests
Editor: How critical is risk stratification in determining treatment options for localized prostate cancer?
Dr. Samuel Johnson: Risk stratification is basic in guiding treatment decisions for prostate cancer that hasn’t spread. Doctors typically consider various factors such as the initial PSA level, Grade Group, T-category from imaging, and biopsy results to categorize the cancer into different risk brackets. this helps in tailoring a more personalized and appropriate treatment plan for each patient.
Editor: Which specific tests and criteria do clinicians commonly rely on for risk assessment?
Dr. Samuel Johnson: Commonly, clinicians use criteria like the T-category (which indicates the extent of the primary tumor), initial PSA levels, the Grade group (a derivation of the Gleason Score), and the results from prostate biopsies. These criteria help doctors understand the aggressiveness of the cancer and predict its potential behavior, thereby shaping the recommended treatment path.
Treatment Outcomes and Research
Editor: Can you discuss some key research studies that highlight the long-term outcomes of different treatment modalities for intermediate-risk prostate cancer?
Dr. Samuel Johnson: Such as,research by D’Amico et al. and Jones et al. have provided insights into the efficacy of various treatments, such as androgen suppression combined with radiation therapy versus radiation alone, or short-term androgen deprivation therapy in combination with radiotherapy. These studies suggest that combination therapies often provide better control of cancer progression without significantly compromising quality of life.
Editor: How do these studies inform current clinical practices?
Dr.Samuel Johnson: These studies have demonstrated the importance of personalized medicine.Depending on the individual risk factors, combining different modalities like radiotherapy and hormonal therapy may yield better outcomes. For instance, Goy et al.’s findings on neoadjuvant deprivation therapy and external radiation emphasize the potential benefits of combining these approaches for certain intermediate-risk patients.
Conclusion
Editor: What are the key takeaways for men diagnosed with intermediate-risk prostate cancer?
Dr. Samuel Johnson: For patients, it’s crucial to understand that while intermediate-risk prostate cancer has a higher chance of progressing compared to low-risk cancer, it can still be managed effectively through tailored treatment strategies. Close monitoring and follow-up with your healthcare provider are essential to adapt treatments as necessary. Lastly, maintaining a balanced approach that considers both survival and quality of life is fundamental.