Optimal Measure of PSA Kinetics to Identify Prostate Cancer
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摘要
Patients with histologically proven PCa and PSA less than 10 ng/ml were selected from the European Randomized Study of Screening for Prostate Cancer, section Rotterdam. The choice of initiating a watchful waiting policy was patient desire or physician advice. PSA slope and PSA doubling time (PSADT) were calculated in patients with 3 or more PSA tests results available.

ss="h4">Results

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.

ss="h4">Conclusions

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.


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Urology

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src="/scidirimg/jrn_nsub.gif" alt="You are not entitled to access the full text of this document" title="You are not entitled to access the full text of this document" width=12 height=14"> sciencedirect.com/science?_ob=ArticleURL&_udi=B6VJW-4S7HWG1-8&_user=10&_coverDate=04%2F08%2F2008&_rdoc=1&_fmt=high&_orig=article&_cdi=6105&_sort=v&_docanchor=&view=c&_ct=8875&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=c9b72a5ef98500737baa3bfdffb5a27b">A Dietary Intervention for Recurrent Prostate Cancer After Definitive Primary Treatment: Results of a Randomized Pilot Trial
UrologyIn Press, Corrected ProofAvailable online 8 April 2008
James Carmody, Barbara Olendzki, George Reed, Victoria Andersen, Penny Rosenzweig

Abstract
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ss="h4">Objectives

Considerable 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">Methods

A 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">Results

The 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">Conclusions

Men 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.


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Copyright © 2008 Elsevier Inc. All rights reserved.

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Optimal Measure of PSA Kinetics to Identify Prostate Cancer

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