Early intervention in prostate cancer: Best approach to treatment

HOUSTON -- (September 24, 2009) -- Early-stage intervention in prostate cancer is the best approach to treatment of the disease, said a urologist at Baylor College of Medicine.

"Before the PSA screening era, one out of every three prostate cancer patients who underwent surgery was too late for intervention," said Dr. Dov Kadmon, professor of urology at BCM and co-leader of the prostate cancer program in the NCI-designated Dan L. Duncan Cancer Center at BCM. "This, and other significant advancements, have given physicians a better understanding of the disease and reaffirm the importance of treating prostate cancer early."

Better, more advanced treatments

Kadmon said physicians now have better, more advanced treatments and approaches to managing treatment-related side effects. They have been able to prolong survival and reduce the incidences of prostate cancer-related mortality and morbidity.

Approximately 190,000 new cases of prostate cancer are expected to be diagnosed this year, Kadmon said, and 27,000 will die from the disease. Prostate cancer, when caught in the early stages (when the cancer has been found only in the prostate gland) is highly treatable and curable, Kadmon said.

PSA early indicator

The introduction of the prostate-specific antigen test about 15 years ago has strongly influenced the ability to catch cancer early, Kadmon said.

"PSA is a protein produced by normal and cancerous prostate cells," said Kadmon. "PSA blood levels are elevated when produced by prostate cancer cells."

Depending on a man's age, there are recommended blood levels that may indicate the need for a biopsy and further treatment.

Standard forms of early prostate cancer treatment include surgery (removal of the prostate gland) and radiation therapy.

"The doctor and patient should jointly decide whether to seek treatment or be watched closely," said Kamdon. "We have a lot more data available today to help them make those decisions."

Patients also have the option of minimally invasive surgeries that reduce time needed for recovery, Kadmon said.

Screening recommendations

Beginning at age 50, it is recommended that men have a PSA or screening test every year. Men with a family history of prostate cancer and African American men should begin yearly screenings at age 40.

Kadmon said men should continue prostate cancer screenings and consider treatment if necessary into their late 70s.

"Physicians should continue pursuing long-term goals of curing prostate cancer and reducing morbidity and mortality," said Kadmon. "There should continue to be an emphasis on the importance of early treatment for the disease."

September is Prostate Cancer Awareness Month.