Thanks to a blog at 'Dan's Journey through Prostate Cancer' I saw this interesting piece of research into PSA levels. The Cornell Chronicle shows that PSA levels do not reflect prostate cancer growth - see the article here. They write:
"The recent study, published in the Journal of Clinical Oncology, analyzed data from more than 2,500 men enrolled in two multinational phase 3 clinical trials testing enzalutamide to slow or stop tumor growth in patients with advanced prostate cancer. This drug targets the androgen receptor, a protein that prostate cancer cells use to receive growth signals from male hormones such as testosterone. The trials (ARCHES and PROSPER) assessed cancer spread or growth on imaging scans, alongside changes in PSA levels during treatment. The researchers examined cases of radiographic progression – when cancer growth or spread is detected by imaging such as X-rays, CT scans or bone scans."
The results showed up to roughly 25% of patients had radiographic prostate cancer progression without any rise in PSA levels, and they had worse outcomes. The study also found that patients often didn't have new symptoms and felt well, despite the cancer advancing. Both groups were similar and this suggests it may be a broad issue across advanced prostate cancer.
The results surprised researchers and they suggest that "patients receiving potent androgen receptor inhibitors such as enzalutamide may benefit from periodic imaging in addition to routine PSA monitoring, particularly during the first two years of treatment".
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