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Publications

Distinguishing prostate-specific antigen bounces from biochemical failure after low-dose-rate prostate brachytherapy.

By:
Contributors: Nawaid Usmani, MD, FRCPC, Sunita Ghosh, PhD
J Contemp Brachytherapy. 2014 Oct;6(3):247-53. doi: 10.5114/jcb.2014.45093. Epub 2014 Sep 5.

Abstract

PURPOSE:

The purpose of this study was to characterize benign prostate-specific antigen (PSA) bounces of at least 2.0 ng/mL and biochemical failure as defined by the Phoenix definition after prostate brachytherapy at our institution, and to investigate distinguishing features between three outcome groups: patients experiencing a benign PSA bounce, biochemical failure, or neither.

MATERIAL AND METHODS:

Five hundred and thirty consecutive men treated with low-dose-rate brachytherapy with follow-up of at least 3 years were divided into outcome groups experiencing bounce, failure, or neither. A benign bounce was defined as a rise of at least 2.0 ng/mL over the pre-rise nadir followed by a decline to 0.5 ng/mL or below, without intervention. Patient and tumor characteristics, treatment variables, and PSA kinetics were analyzed between groups.

RESULTS:

Thirty-two (6.0%) men experienced benign bounces and 47 (8.9%) men experienced failure. Men experiencing a bounce were younger (p = 0.01), had a higher 6-month PSA level (p = 0.03), and took longer to reach a final nadir (p < 0.01). Compared to the failure group, men with bounce had a lower pre-treatment PSA level (p = 0.01) and experienced a rise of at least 2.0 ng/mL that occurred sooner after the implant (p < 0.01) with a faster PSA doubling time (p = 0.01). Only time to PSA rise independently differentiated between bounce and failure (p < 0.01), with a benign bounce not being seen after 36 months post-treatment. Prostate-specific antigen levels during a bounce reached levels as high as 12.6 ng/mL in this cohort, and in some cases took over 5 years to decline to below 0.5 ng/mL.

CONCLUSIONS:

Although there is substantial overlap between the features of benign PSA bounces and failure, physicians may find it useful to evaluate the timing, absolute PSA level, initial response to treatment, and rate of rise when contemplating management for a PSA rise after low-dose-rate brachytherapy.

PubMed

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It’s Movember, time to Grow a Mo for a Bro!

It’s Movember, time to grow your moustache to raise funds and awareness of some serious health risks that men face, like suicide, testicular cancer and prostate cancer. Maybe growing a moustache isn’t your thing? No problem, host a Mo-ment for the men in your life instead!

APCaRI is a key stakeholder in the TrueNTH Global Registry; contributing 92% of the submitted patients in February 2018. Recently described by Evans et al., 2017 in an article published in BMJ Open, this project was established as an international registry with the goal to monitor the care of men with localised prostate cancer from 13 Movember-fundraising countries. Prostate cancer treatment and outcomes for men vary according to where they live, their race and the care they receive. The TrueNTH Global Registry is collecting a dataset based on the International Consortium for Health Outcome Measures (ICHOM) so we can better understand how to improve the care and treatment of men with localized prostate cancer, regardless of ethnicity and geography.

Please check out previous APCaRI blog posts that have talked about Movember (@Movember); the international Mens’ health Awareness charity, and about TrueNTH (@TrueNTH_Canada); a program funded by Prostate Cancer Canada (PCC) and the Movember Foundation that aims to improve the quality of life of men with prostate cancer and their families.

So start growing (or attach) your moustache today to raise funds and awareness to improve mens’ health!

- Perrin Beatty