Copyright © 2008 Elsevier Inc. All rights reserved.
ss="h4">Ambulatory and Office Urology
Optimal Measure of PSA Kinetics to Identify Prostate Cancer
A total of 191 patients were included. Mean age at diagnosis was 69 years and mean PSA was 3.9 ng/ml. Of the patients 92.6%had a Gleason score of 3 + 3 or lower, 133 had a followup of greater than 12 months (mean 40) and 35 (29.2%) had a negative PSA slope. Mean PSADT was 9.7 years (range 0.3 to 155) in 85 males with a positive PSA slope. During followup 30 patients changed therapy.
Watchful waiting remains a controversial prostate cancer treatment strategy. In select screening detected patients with PCa there appears to be a subgroup with stable or even decreasing PSA values with time. These males could profit from a watchful waiting policy with possible deferred treatment. Together with conventional tumor parameters at diagnosis PSADT and PSA slope during followup could be used to monitor tumor activity and possibly aid in determining the time of deferred treatment. Further followup is mandatory to validate these results.
style="float:right; padding-left:5px"> Urology, In Press, Corrected Proof, Available online 8 April 2008 James Carmody, Barbara Olendzki, George Reed, Victoria Andersen, Penny Rosenzweig Abstract ss="mlktScroll"> style="line-height:150%"> ss="h4">ObjectivesConsiderable evidence has shown that diet can affect both the incidence and the progression of prostate cancer. The objective of this study was to determine whether men in this situation could make a change to a diet emphasizing plant-based foods and fish and to examine the effect on quality of life (QOL) and prostate-specific antigen (PSA) velocity.ss="h4">MethodsA total of 36 men and their partners were randomly assigned to attend a series of 11 dietary and cooking classes that also integrated mindfulness practice as a support in making the change or a wait-list control group. Assessments were made of dietary intake, QOL, and PSA at baseline, after intervention (11 weeks), and 3 months after intervention. ss="h4">ResultsThe intervention group showed significant reductions in the consumption of saturated fat and increased consumption of vegetable proteins with accompanying reductions in animal proteins, including dairy products. They also showed increased QOL. Although no significant change was found in the rate of PSA increase between the two groups, the mean PSA doubling time for the intervention group was substantially longer at the 3-month follow-up visit than that of the controls. ss="h4">ConclusionsMen with a increasing PSA level after primary treatment were able to make a change to a prostate-healthy diet, accompanied by increases in QOL. No significant difference was found in the log PSA slope between the two groups; however, the PSA doubling time increased substantially in the intervention group compared with that in the controls. Future trials should examine the effect of the prostate-healthy diet with a larger sample of men for a longer period. sciencedirect.com/science?_ob=MImg&_imagekey=B6VJW-4S7HWG1-8-1&_cdi=6105&_user=10&_orig=article&_coverDate=04%2F08%2F2008&_sk=999999999&view=c&wchp=dGLbVlW-zSkWb&md5=00797ed76d052d8ddc7dbbddae231851&ie=/sdarticle.pdf"> |
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Optimal Measure of PSA Kinetics to Identify Prostate Cancer