What evidence is there that Prostate Cancer can increase in grade
when untreated.. ie Gleason scors rising at serial biopsies...I can
only fnd one article.. |
Request for Question Clarification by
pafalafa-ga
on
02 Dec 2005 11:49 PST
Thanks for sending this my way. I'll look into it, but it would help
to know what article you found thus far.
It would also help to have some preliminary feedback on this article:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2468794&dopt=Abstract
Prostate specific antigen in the diagnosis and treatment of
adenocarcinoma of the prostate. I. Untreated patients.
As I read it, it says that PSA, Gleason score, and advancing stage of
cancer are all correlated with one another. The correlation is with
cancer stage, rather than tumore grade, so I want to know if this is
on or off target for you, and any other guidance you might have about
the value (or lack thereof) for this particular article.
Thanks,
paf
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Clarification of Question by
elizabethfaiella-ga
on
02 Dec 2005 13:45 PST
http://www.jurology.com/pt/re/juro/pdfhandler.00005392-200111000-00017.pdf;jsessionid=DUD6gpINwvP1ajMVlp8KHdXkgs5stGsd0zm3CP92jEd9G9Mgbiuc!-1932480194!-949856144!9001!-1?index=1&database=ppvovft&results=1&count=10&searchid=1&nav=search
This is the one I found by Epstein
This patient has a PSAof 7, a normal rectal exam, unnown grade( as no
biopsy was done for a year), and then was diagnosed with a gleaseon 9,
metastatic to lungs and bones cancer. The defense is that it was
probably a Gleason 9 a year earlier... no harm done by the clearly
negligent failure to biopsy..That grade 9 begins as a grade 9 and
stays there.... I am looking for reasearch showing grade can
increase.. ie aggressiveness can increase ... ie early intervention
can keep patient from developing aggressive grade 9....( as my expert
says..) Someone named Kassouf has done some work on this but I can't
find it. thanks Elizabeth
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Clarification of Question by
elizabethfaiella-ga
on
02 Dec 2005 14:55 PST
Epstein is the author of the article against the proposition I seek
to support... I think there may be conflicting data and that is what I
am searching for...
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Request for Question Clarification by
pafalafa-ga
on
02 Dec 2005 15:11 PST
Elizabeth,
I don't have full access to all my online medical sources right now,
but I at least wanted to get the ball rolling with one abstact:
http://www.jurology.com/pt/re/juro/abstract.00005392-200204000-00020.htm;jsessionid=DQTfYtE1rGTuCJzv9c20pAC0dh4SlX5NOY1pB22i8rv4Jsx61BTf!1981085828!-949856144!9001!-1
Feasibility Study: Watchful Waiting For Localized Low To Intermediate
Grade Prostate Carcinoma With Selective Delayed Intervention Based On
Prostate Specific Antigen, Histological And/Or Clinical Progression.
I don't have access to the full article right now. But I believe the
reference to "histological upgrades/progression" in 5 patients is
talking about increased Gleason scores.
If you can access the full article, have a look, and let me know what
you think. Meanwhile, I'll keep looking.
paf
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