Predicting Prostate Cancer’s Moves
New tests could refine therapy decisions
By Ben Harder
When a man’s physician diagnoses prostate cancer, difficult decisions about the patient’s treatment course lie ahead. Surgery or radiation therapy could either extend life or needlessly impair the man’s quality of life. Two decades ago, a diagnosis of prostate cancer was tantamount to a death sentence. Physicians detected the cancer mainly through a physical exam of the rectum, which usually identified abnormal growths too late for surgery to stop the cancer from spreading throughout the body.
That’s no longer the case. Prostate cancer diagnosis changed dramatically with the discovery in 1979 of a protein known as prostate-specific antigen (PSA) and the introduction in the late 1980s of a test that measures its concentration in the blood. Today, urologists consider a high concentration of PSA to reflect abnormal prostate growth, which is often a sign of cancer in that gland. Although the test doesn’t pick up all cases, many men today are diagnosed with early-stage prostate cancer that has yet to cause symptoms or spread beyond the gland.