There are many treatment options available for persons with prostate cancer. A recent emphasis in determining the most effective treatment strategy has been focused on individualizing therapy for each patient according to differing biological characteristics of the cancer. There are two important benefits of individualizing therapy: 1) the achievement of optimal treatment strategies for each patient, and 2) the sparing of some patients from unnecessary treatment. Results from a recent clinical study published in the journal

Cancer indicate the effectiveness of a new inexpensive method to help identifty patients who are at high risk for a cancer recurrence following a radical prostatectomy (surgical removal of the prostate gland and surrounding tissue). These high-risk patients may benefit from additional therapy to prevent recurrences while patients not at high-risk may be spared from additional therapy and related side effects.

The prostate is a male sex gland that is located between the bladder and the rectum. Cancer of the prostate occurs commonly in older men. A few tests presently exist that help predict if a patient is at high-risk for a cancer recurrence, including blood prostate specific antigen levels (levels of a protein produced by the prostate), Gleason score (determination of the aggressiveness of the cancer), abnormalities in DNA and the spread of cancer. Recently, researchers from Washington University conducted a study evaluating the accuracy of a new method in identifying patients at a high-risk for a cancer recurrence following a radical prostatectomy. This method involves microscopic examination of prostate tissue specimens following surgery to determine the amount, or percentage of cancer present in the prostate.

Almost 600 men with localized prostate cancer (cancer that has not spread outside the prostate) were evaluated using a microscopic visual estimate of prostate tissue samples. This study was to determine if the percentage of cancer in the prostate had a direct association with the risk of a cancer recurrence. In the group of patients that did not have a recurrence, the average percentage of cancer in the prostate specimen was 11%, and in the group of patients who did have a recurrence the average percentage of cancer was 24%. For each 5% increase in the percentage of cancer present in the surgical specimen, there was an 11% increase in the chance of a cancer recurrence. These results suggest that visual estimates of the amount of cancer present in the prostate may help to predict patients at high-risk for a recurrence. To increase accuracy for prediction of a recurrence, the researchers developed a model that included a Gleason score, extent of disease, and visual estimates of the quantity of cancer present.

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The researchers concluded that a visual estimate of the percentage of cancer in prostate specimens from patients who undergo a radical prostatectomy is a practical, simple, and inexpensive method that provides important information about the likely risk of a cancer recurrence, which can help determine appropriate treatment strategies. Persons with prostate cancer may wish to speak with their doctor about the risks and benefits of participating in a clinical trial further evaluating this method or other promising new treatment strategies. Two sources of ongoing information that can be discussed with a doctor include comprehensive, easy-to-use services provided by the National Cancer Institute (cancer.gov) and eCancerTrials.com. eCancerTrials.com also performs personalized clinical trial searches on behalf of patients. (Cancer, Vol 89, No 6, pp 1308-1314, 2000)

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