Frequent PSA Testing May Not Be Beneficial for All Prostate Cancer Survivors
Research highlights the need for new prostate specific antigen testing guidelines.
Early detection of prostate cancer recurrence is considered crucial for providing potentially life-saving treatment. Prostate cancer survivors are, therefore, regularly monitored for markers of recurrence.
Some patients, particularly older males with a low cancer risk and lower life expectancy, may experience complications from frequent monitoring of prostate specific antigens (PSA), according to a study published by the Journal of General Internal Medicine.
The authors found that it could be dangerous to perform the same monitoring procedures among all patients. The study suggests that a patient’s overall health and prognosis should be considered when determining how frequently to monitor them.
Physicians need to individualize monitoring for older prostate cancer survivors to mitigate the potential harms of screening, according to the study.
The authors suggest that new guidelines for PSA monitoring should consider patient life expectancy, the risk of recurrence, and the values or preferences of survivors.
Intervention may be beneficial for some patients after early detection of recurrence based on PSA levels.
Monitoring PSA levels can cause complications related to the invasive nature of the diagnostic procedure, according to the study. The authors noted that this may be dangerous for older men who have a history of low-risk cancer or a limited life expectancy.
Researchers examined data from 13,397 men 65 years and older who were diagnosed with prostate cancer between 2003 and 2008. All of the individuals were treated with radiation or radical prostatectomy with a median follow-up period of 4 years.
A majority of patients received 2 PSA tests per year, despite other characteristics that may have influenced recurrence risk, according to the study.
Older patients with a limited life expectancy and low-risk cancer had the lowest risk of recurrence. These patients were also found to have the highest risk of complication from PSA monitoring.
Furthermore, these patients received nearly the same amount of PSA tests as younger men with high-risk cancer, who are most likely to benefit from monitoring, according to the study. Currently, physicians typically review time since treatment to determine how often a patient should receive a PSA test, while not considering other factors, according to the authors.
The study revealed a narrow range of PSA testing frequency among other characteristics, which suggests physicians are not tailoring the frequency of testing for each patient.
The authors hope these findings may result in new guidelines for PSA monitoring among prostate cancer survivors, with a focus on more individualized screening recommendations.