Metastatic prostate cancer cases rising, study finds

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The number of deadly metastatic prostate cancer cases increased considerably in the last decade, potentially due to a recent decrease in the number of men screened for disease, according to a new study.

The Northwestern Medicine study released Tuesday analyzed the information of 767,550 men who had been diagnosed with prostate cancer between the years 2004 and 2013, and found that the number of new cases rose to 72 percent within the last decade.

The largest increase in new cases— 92 percent— was amongst men between the ages 55 and 69. This finding is particularly troubling, researchers noted, because men in this age group are believed to benefit most from prostate cancer screening and early treatments.

Researchers also observed an increase in average Prostate-Specific Antigen (PSA) levels in men who were diagnosed with metastatic prostate cancer, suggesting a greater extent of the disease at diagnosis. PSA is a protein made in the prostate gland that is often elevated in men with prostate cancer, and is used to test for the disease in patients.

The average PSA level, the study found, was 49 in 2013, compared to 25 in 2004.

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“One hypothesis is the disease has become more aggressive, regardless of the change in screening,” study senior author Dr. Edward Schaeffer, chair of urology at Northwestern University Feinberg School of Medicine and Northwestern Medicine, said in a news release. “The other idea is since screening guidelines have become more lax, when men do get diagnosed, it’s at a more advanced stage of disease.”

The study, published in Prostate Cancer and Prostatic Diseases, also cites a substantial decline in the number of men being screened for prostate cancer, as well as an associated decrease in the overall number of new cases of prostate cancer reported.

Treatment can be curative in patients diagnosed with an aggressive, localized prostate cancer, the study said. However, metastatic prostate cancer, a form of cancer in which the malignant cells have spread to other parts of the body, is not curable and treatments only slow the progression of the disease.

Most men that present with metastatic prostate cancer eventually die from the disease, and, according to Schaeffer, there may be a significant increase in the death rate due to prostate cancer if patients are diagnosed with the metastatic stage of the disease. Researchers hope that the study’s findings will result in changes to current screening guidelines.

“The results indicate that screening guidelines and treatment need to be refined based on individual patient risk factors and genetics,” lead author Dr. Adam Weiner, a Feinberg urology resident, said in a press release. “This may help prevent the growing occurrence of metastatic prostate cancer and potential deaths associated with the disease.”

Researchers said men who fall under the U.S Preventative Taskforce guidelines should get screened for prostate cancer, as early detection is crucial in the fight against the disease. Current guidelines specify that men should speak to their doctor about being tested if they are over 50, are an African American male over the age of 45, or have a family history of prostate cancer

“If I were a patient, I would want to be vigilant.” Schaffer said.  “I firmly believe that PSA screening and rectal exams save lives.”