No Survival Bump With More Frequent PSA Screens for Localized Prostate Cancer

Excerpt:

“Undergoing more frequent prostate-specific antigen (PSA) screening after radical prostatectomy or primary radiation for localized prostate cancer was not associated with improved overall survival (OS), regardless of disease risk, according to results of the AFT-30 study (abstract 6503) presented at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting, held June 1–5 in Chicago.

“‘Based on our study results, PSA testing every 3 to 6 months may represent overutilization of care,’ said Ronald Chen, MD, of the University of North Carolina at Chapel Hill. ‘This study provides empiric data to inform future guidelines and clinical practice.'”

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Many Women With Breast Cancer May Not Need Chemo, but Beware Misleading Headlines

Excerpt:

Findings from a major international clinical trial suggest a significant number of women with the most common form of early-stage breast cancer do not need chemotherapy after surgery.

“The results of the so-called TAILORx trial were presented yesterday at the annual meeting of the American Society of Clinical Oncology and concurrently published in the New England Journal of Medicine.”

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Study Finds More Than 40 Percent of Prostate Biopsies Could Be Avoided with New Blood Test

Excerpt:

A multi-center study that validates the clinical performance of IsoPSA—a new blood test that has proven to be more accurate in predicting overall risk of prostate cancer than standard prostate-specific antigen (PSA) – will be presented during a special press conference at the 13th Annual Meeting of the American Urological Association (AUA) on May 18 in San Francisco.

“Results showed that more than 40 percent of biopsies could have been avoided in both the preliminary study (45.1 percent) and validation study (47 percent), suggesting that use of IsoPSA may substantially reduce the need for , and may thus lower the likelihood of overdetection and overtreatment of nonlethal  cancer.”

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Test Identifies Breast Cancer Patients With Lowest Risk of Death

Excerpt:

“A molecular test can pinpoint which patients will have a very low risk of death from breast cancer even 20 years after diagnosis and tumor removal, according to a new clinical study led by UC San Francisco in collaboration with colleagues in Sweden. As a result, ‘ultralow’ risk patients could be treated less aggressively and overtreatment avoided, leading to fewer toxic effects.

” ‘This is an important step forward for personalizing care for women with ,’ said lead author Laura J. Esserman, MD, MBA, a breast cancer specialist and surgeon with UC Health. ‘We can now test small node-negative breast cancers, and if they are in the ultralow risk category, we can tell women that they are highly unlikely to die of their cancers and do not need aggressive treatment, including radiation after lumpectomy.’ ”

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New Blood Test Is More Accurate in Predicting Prostate Cancer Risk Than PSA

Excerpt:

“A team of researchers from Cleveland Clinic, Louis Stokes Cleveland VA Medical Center, Kaiser Permanente Northwest, and other clinical sites have demonstrated that a new blood test known as IsoPSA detects prostate cancer more precisely than current tests in two crucial measures — distinguishing cancer from benign conditions, and identifying patients with high-risk disease.

“By identifying molecular changes in the prostate specific antigen (PSA) protein, the findings, published online last month by European Urology, suggest that once validated, use of IsoPSA may substantially reduce the need for biopsy, and may thus lower the likelihood of overdetection and overtreatment of nonlethal prostate cancer.”

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Thousands of Men with Prostate Cancer Get Risky Treatment They Don’t Need. New Approaches Could Curb That

Excerpt:

“They look like glowing jade necklaces of such unearthly brilliance they could be a Ming emperor’s. But if Dr. Gerardo Fernandez is right, the green fluorescent images of prostate cells could be even more valuable, at least to the thousands of men every year who unnecessarily undergo aggressive treatment for prostate cancer.

“That’s because the glimmering images promise to show which prostate cancers are destined to remain harmless for the rest of a man’s life, and thus might spare many patients treatment that can cause impotence and incontinence.”

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Active Surveillance of Prostate Cancer Associated with Favorable Outcomes in Younger Men

Excerpt:

“Younger age was associated with lower risks for disease progression and biopsy-based Gleason score upgrades during active surveillance of low- or intermediate-risk prostate cancer, according to a study published in Journal of Clinical Oncology.

” ‘The results of this study indicate that younger patients with low-risk prostate cancer experienced favorable outcomes when managed with active surveillance at nearly 5-year median follow-up,’ Michael Leapman, MD, assistant professor in the department of urology at Yale University School of Medicine, told HemOnc Today. ‘Younger patients have conventionally been counseled to receive definitive treatment, even in the setting of low-risk disease. This study is impactful as it may expand the use of surveillance, potentially limiting the harms of overtreatment for patients with screening-detected low-grade tumors.’ ”

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Prostate Cancer Specialists Argue for Early Chemo

Excerpt:

“Recent studies have reopened discussion of a seemingly closed case against earlier use of chemotherapy in prostate cancer.

“Chemotherapy has an established role in the management of metastatic castration-resistant prostate cancer, but its use in earlier-stage disease has remained controversial. Given the heterogeneous nature of the disease, prolonged clinical course associated with indolent disease, and concern about overdiagnosis and overtreatment, clinicians have reached no consensus about potential patient subgroups that might benefit from earlier use of chemotherapy. Differences of opinion played out again in pro/con articles published online in JAMA Oncology.”

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Do Second Opinions Matter in Prostate Cancer Care?

Excerpt:

“A new analysis indicates that many men with prostate cancer obtain second opinions from urologists before starting treatment, but surprisingly, second opinions are not associated with changes in treatment choice or improvements in perceived quality of prostate cancer care. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings also explore motivations for seeking second opinions, and suggest that second opinions may not reduce overtreatment in prostate cancer.”

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