Cancer reappears in nearly one out of three men who undergo surgical removal of the prostate gland for treatment of prostate cancer, a new study indicates.
According to the American Cancer Society, more than 140,000 new cases of prostate cancer are diagnosed in the United States annually. Prostate cancer is the second leading cause of cancer death among American men — trailing only lung cancer. Nearly 40,000 men die annually of prostate cancer — roughly 1 every 15 minutes.
Horst Zincke, M.D., Ph.D., and Michael L. Blute, M.D., and colleagues at Mayo Clinic, Rochester, Minn., followed 2,782 men with prostate cancer who had surgical removal of the prostate gland (radical prostatectomy) and neighboring lymph nodes between 1987 and 1993.
The average age of participants was 66 at the time of surgery. The researchers then monitored blood levels of prostate specific antigen (PSA), which can be an indicator of recurrent prostate cancer, and performed other tests seeking evidence of the return or spread of the disease.
PSA is an enzyme made by prostate tissue that dissolves the proteins that cause semen to clump. Levels can be checked using a simple blood test. Besides cancer, PSA levels may increase due to age, sexual activity and a variety of factors other than cancer.
The study, which appears in the July issue of The Journal of Urology, found that cancer returned in 29 percent of the men studied. The highest rate of recurrence was during the first 2 years after radical prostatectomy for the group overall.
"We've learned, for sure, from this study that prostate cancer, like breast cancer in the woman, can recur in a man 5, 10 or more years after surgery," says Dr. Zincke. "The PSA test can detect the recurrence of the cancer, which then allows for prompt treatment."
Dr. Zincke says the findings indicate that a man cannot be considered cancer-free if the disease has not recurred within 5 years of having a prostatectomy — the guideline used by many physicians.
The researchers say the results indicate that men should remain vigilant following a prostatectomy. They recommend a PSA test as part of an annual physical examination for men who undergo the surgery.
Radical prostatectomy is considered by many to be the best treatment for cancer that is localized to the prostate and is the most frequently performed treatment for prostate cancer in the United States. According to the Mayo Clinic data, men undergoing the surgery for prostate cancer have a better than 90 percent chance of living 10 years after surgery.
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