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From Winter 2013 Quest

European Study: PSA Testing Reduces Prostate Cancer Deaths

Recent results from the European Randomized Study of Screening for Prostate Cancer showed that PSA-based screening lowered the risk of prostate cancer mortality by 32% for men who were 55-69 years old at the start of the trial, and starting screening for men at age 70 was ineffective. The authors concluded that PSA-based screening can reduce prostate cancer deaths, but it is hindered by the inability to specifically identify all men at risk of developing aggressive or fatal prostate cancer.

Roobol, M., et al. Screening for prostate cancer: results of the Rotterdam section of the European randomized study of screening for prostate cancer. Eur Urol. 2013; 64(4):530-9.

Stratifying Active Surveillance Criteria by Race

A new study compared African-American and Caucasian men who were eligible for active surveillance at the time of their diagnoses. African-American men were twice as likely to develop non-organ confined cancer. The authors concluded that more stringent active surveillance criteria may be necessary for African-American men and further study is necessary.

Ha, YS., et al. Increased incidence of pathologically nonorgan confined prostate cancer in African-American men eligible for active surveillance. Urology. 2013; 81(4):831-5.

Obesity Increases BPH Risk

Researchers found an association between body mass index (BMI), waste circumference and prostate volume. Obese men with BMIs greater than 35 had a 41% greater risk of having benign prostatic hyperplasia (BPH) than non-obese men with BMIs less than 25. BPH, a non-cancerous enlargement or growth in the prostate, has been considered to be an inevitable result of genetic disposition and age.

Parsons, J., et al. Obesity and benign prostatic hyperplasia: clinical connections, emerging etiological paradigns and future directions. J Urol. 2013; 189(1 Suppl):S102-6.

Male Pattern Baldness and Prostate Cancer

There is a hypothesized link between male pattern baldness and prostate cancer because of their similar risk factors of aging, androgens and family history. A recent study found that men with vertex pattern (back of the head) baldness had a significantly increased risk of prostate cancer. However, patients with any baldness did not have an increased risk.

Amoretti A., et al. Androgenetic alopecia and risk of prostate cancer: a systematic review and metaanalysis. J Am Acad Dermatol. 2013; 68(6):937-43

Beta-Blockers Lower Prostate Cancer Mortality

Men with high-risk or metastatic prostate cancer who used betablockers had a 21% decreased risk of prostate cancer-specific death, according to a recent study. The reduction was independent of the use of statin and aspirin, and researchers did not find a link between betablocker use and all-cause mortality.

Grytli H., et al. Association Between Use of β-Blockers and Prostate Cancer-Specific Survival: A Cohort Study of 3561 Prostate Cancer Patients with High-Risk or Metastatic Disease. Eur Urol. 2013; pii: S0302-2838(13)00010-9.

Blood in Urine Found Years after Brachytherapy

Men can experience hematuria, or blood in the urine, several years after having brachytherapy treatment for prostate cancer, according to a recent study of 2,454 patients who had radioactive seeds implanted over a 20-year period. The median time to the first hematuria episode was more than 2 years, and 25% of the men had hematuria more than 5 years after having brachytherapy. Men with larger prostates (more than 40 cm3) were more likely to have blood in their urine, as were men who had external beam radiotherapy and men who were free from biochemical failure.

Leapman M., et al. Hematuria after prostate brachytherapy. BJU Int. 2013; 111(8):E319-24.

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