Predicting Outcomes and Characterizing Prostate Tumors.

Boca Pass toward Cayo Costa, Boca Grande, Florida. bjgabrielsen photo.
Boca Pass toward Cayo Costa, Boca Grande, Florida.
bjgabrielsen photo.

For a newly-diagnosed prostate cancer patient, the three most important initial parameters are the blood levels of prostate-specific antigen (PSA) and its rate of increase, the biopsy-based Gleason score that ranks a tumor’s aggressiveness, and the clinical stage of the tumor based on its physical appearance. In the early 1990’s, Dr. Alan Partin, currently director of Urology at the Johns Hopkins Hospital in Baltimore, MD, formulated the Partin Tables using data comprised of the three parameters above as a statistical modeling tool to predict the stage of cancer spread at the time of performing a radical prostatectomy and to assess the chance of a surgical cure. These tables were based primarily on data from men treated in the 1980’s who often were diagnosed with later-stage cancers. The tables have recently been updated with data from over 5,000 men treated at Johns Hopkins between 20o6-2011 and published in the British Journal of Urology International. The revised study found that men treated during this period were more likely to be diagnosed before their PSA had risen significantly and were more likely to have a Gleason score greater than six (6) at the time of biopsy. According to Dr. Partin and his colleagues, the updated Partin Tables show that “surgical cure may be possible for a greater percentage of men especially those whose Gleason scores (such as 8) put them at the high end of intermediate risk.” The updated tables also found that the majority of men who are diagnosed prior to surgery with intermediate Gleason scores of 6 or 7 had a very low (less than 2%) risk of having prostate cancer spread to surrounding lymph nodes. These terms are defined and discussed in more detail in an article published in the January 2013 issue of NewsPulse from the Prostate Cancer Foundation.

The Johns Hopkins Prostate Disorders Health Alerts recently published (Feb. 14th, 2013) a short article defining the terms used in the TNM (tumor, nodes, metastasis) staging system used to define a cancer’s clinical stage or how far it has spread. The TNM prostate cancer staging system is a predictor of the extent of the disease and is useful in choosing the best course of treatment.

A related study describing the effects of exercise on prostate cancer survival was recently published in the Journal of Clinical Oncology and summarized in the January 24th issue of the Johns Hopkins Prostate Disorders Health Alerts. Data was received from 2,705 men followed for a period of 18 years. The study concluded that any type of regular exercise improved overall prostate cancer survival regardless of the intensity of the exercise. However, men who took part in vigorous activity, defined as at least three hours of intensive exercise per week, had a significantly lower (61%) risk of dying from prostate cancer.

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