February 15th, 2011
08:11 PM ET
Less may be more when it comes to prostate cancer screening, says a new study released this week at the Genitourinary Cancers Symposium in Orlando, Florida.
A study by Dutch researchers found that men whose first prostate-selective antigen or PSA blood test came back under 3.0 may not need annual testing; and those with levels under 2.0 can most likely go eight years before getting retested.
"The rate of cancer is very low in men with PSAs less than 3," said Dr. Nicholas Vogelzang, a spokesman for the American Society of Clinical Oncology, and moderator of the conference.
The study went on to say that men with PSA levels of 3 or higher should have prostate biopsies - a more aggressive standard than current recommendations, which suggest a biopsy in men with PSA levels over 4.
If and when to test men's PSA levels has been the subject of controversy in recent years. Many leading experts say testing, without knowing whether slightly elevated PSA levels will ever lead to cancer, can cause unnecessary anxiety for men.
A second study released at the same conference addressed treatments for men who fell into the "watchful waiting" category of of treatment for prostate cancer - a group of men who have some cancer cells in their prostates, but for whom the treatment may be more damaging than the disease itself; and who may die of other causes long before prostate cancer would kill them.
"This is an important paper because of this increasing anxiety that men feel as they are under 'watchful waiting,'" Vogelzang said.
According to the study, men who may be anxious about simply "keeping an eye on things," may benefit from taking the drug dutasteride (Avodart), which is currently used for non-cancerous prostate enlargement.
"With dutasteride, the PSA levels drop by about 50% or so," he said. "It seems to make the gland smaller, causes men to have less urinary symptoms, and may even reduce the amount of cancer in the gland."
A final study released Tuesday suggests that for men who opt to have robot-assisted prostate surgery, choosing a surgeon that has done more operations could provide the highest chances of success. Researchers found that surgeons had to perform more than 1,600 procedures before they were considered experts and had the skills to remove all evidence of cancer in most cases.
"The argument to be made is that it may be more sensible to use robots in a few centers of excellence," Vogelzang said, "rather than small hospitals buying them, and naive surgeons being asked to use them."
The researchers also encouraged doctors who want gain proficiency in the procedure to train at these large centers of excellence.
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