More on relationship between prostate size and cancer risks

[Guest guest]

Several studies have pointed out that the potential aggressiveness of prostate cancer,

as evidenced by the Gleason sum, decreases with prostate size.

IE, if you have been diagnosed with prostate cancer, the smaller the prostate

at diagnoses, the higher the risk that the cancer is aggressive.

However, there have been no compelling theories as to why this is so.

One school of thought was that higher-risk cancers are more apt to be missed

in biopsies of large prostates-- ie the sampling error increases with prostate size.

The abstract below seems to indicate that the relationship of decreased

Gleason scores with increased prostate size is also present in prostates

analyzed after removal by RP, indicating that the relationship is real, not

just a function of biopsy sampling error.

Now the challenge is to figure out why.

Meanwhile, this is one more item to consider in treatment decisions.

The Best to You and Yours!

Jon in Nevada

----------------------------------------------------------------

Is There a Relationship Between Prostate Volume and Gleason Score? - Abstract Friday, 30 May 2008 Mir MC, Planas J, Raventos CX, de IM, Trilla E, Cecchini L, Orsola A, Morote J.

Departments of Urology and Pathological Anatomy, Vall d’Hebron Hospital, Autonoma University School

of Medicine, Barcelona, Spain.

To review the relationship between the Gleason grade and prostate volume in biopsy and radical

prostatectomy (RP) specimens, and thus assess the hypothesis that smaller prostates have a greater

incidence of high-grade tumours.

We selected 390 patients who had RP at our institution, with a prostate-specific antigen (PSA) level of

<10 ng/mL and who had not had hormonal therapy. We retrospectively reviewed the data for transrectal

ultrasonography (TRUS)-guided prostate biopsies from these patients and the RP specimens. Indications

for biopsy included a PSA level of >/=4 ng/mL or an abnormal digital rectal examination. High-grade

tumours were defined as having a Gleason score of >/=7.

The TRUS volume was statistically related to the rate of high-grade tumours at biopsy and RP. On

multivariate analyses, TRUS volume was a significant predictor of high-grade tumour for biopsy and RP

specimens, with an inverse relationship between high-grade tumours and prostate volume for biopsy and

RP specimens.

Our data suggest that there is a relationship between the rate of high-grade tumours and prostate volume

even in biopsy and RP specimens and it is not an artefact related to the biopsy.

Reference BJU Int. 2008 May 12. Epub ahead of print. doi:10.1111/j.1464-410X.2008.07696.x

PubMed Abstract PMID:18476971

UroToday.com Prostate Cancer SectionGet trade secrets for amazing burgers. Watch "Cooking with Tyler Florence" on AOL Food.

[Guest guest]

Fascinating (and pertinent, at least in my situation) stuff. Thanks for sharing it.

>> Several studies have pointed out that the potential aggressiveness of > prostate cancer,> as evidenced by the Gleason sum, decreases with prostate size.> IE, if you have been diagnosed with prostate cancer, the smaller the prostate> at diagnoses, the higher the risk that the cancer is aggressive.> > However, there have been no compelling theories as to why this is so.> One school of thought was that higher-risk cancers are more apt to be missed> in biopsies of large prostates-- ie the sampling error increases with > prostate size.> > The abstract below seems to indicate that the relationship of decreased > Gleason scores with increased prostate size is also present in prostates> analyzed after removal by RP, indicating that the relationship is real, not> just a function of biopsy sampling error.> > Now the challenge is to figure out why.> > Meanwhile, this is one more item to consider in treatment decisions.> > The Best to You and Yours!> > Jon in Nevada> > ----------------------------------------------------------------> Is There a Relationship Between Prostate Volume and Gleason Score? - > Abstract > > Friday, 30 May 2008 > Mir MC, Planas J, Raventos CX, de IM, Trilla E, Cecchini L, Orsola A, > Morote J.> Departments of Urology and Pathological Anatomy, Vall d’Hebron Hospital, > Autonoma University School > of Medicine, Barcelona, Spain. > > To review the relationship between the Gleason grade and prostate volume in > biopsy and radical > prostatectomy (RP) specimens, and thus assess the hypothesis that smaller > prostates have a greater > incidence of high-grade tumours.> > We selected 390 patients who had RP at our institution, with a > prostate-specific antigen (PSA) level of > <10 ng/mL and who had not had hormonal therapy. We retrospectively reviewed > the data for transrectal > ultrasonography (TRUS)-guided prostate biopsies from these patients and the > RP specimens. Indications > for biopsy included a PSA level of >/=4 ng/mL or an abnormal digital rectal > examination. High-grade > tumours were defined as having a Gleason score of >/=7.> > The TRUS volume was statistically related to the rate of high-grade tumours > at biopsy and RP. On > multivariate analyses, TRUS volume was a significant predictor of high-grade > tumour for biopsy and RP > specimens, with an inverse relationship between high-grade tumours and > prostate volume for biopsy and > RP specimens.> > Our data suggest that there is a relationship between the rate of high-grade > tumours and prostate volume > even in biopsy and RP specimens and it is not an artefact related to the > biopsy.> > Reference BJU Int. 2008 May 12. Epub ahead of print. > doi:10.1111/j.1464-410X.2008.07696.x> PubMed Abstract PMID:18476971> UroToday.com Prostate Cancer Section> > > > **************Get trade secrets for amazing burgers. Watch "Cooking with > Tyler Florence" on AOL Food. > (http://food.aol.com/tyler-florence?video=4 & ?NCID=aolfod00030000000002)>

[Guest guest]

Fascinating (and pertinent, at least in my situation) stuff. Thanks for sharing it.

>> Several studies have pointed out that the potential aggressiveness of > prostate cancer,> as evidenced by the Gleason sum, decreases with prostate size.> IE, if you have been diagnosed with prostate cancer, the smaller the prostate> at diagnoses, the higher the risk that the cancer is aggressive.> > However, there have been no compelling theories as to why this is so.> One school of thought was that higher-risk cancers are more apt to be missed> in biopsies of large prostates-- ie the sampling error increases with > prostate size.> > The abstract below seems to indicate that the relationship of decreased > Gleason scores with increased prostate size is also present in prostates> analyzed after removal by RP, indicating that the relationship is real, not> just a function of biopsy sampling error.> > Now the challenge is to figure out why.> > Meanwhile, this is one more item to consider in treatment decisions.> > The Best to You and Yours!> > Jon in Nevada> > ----------------------------------------------------------------> Is There a Relationship Between Prostate Volume and Gleason Score? - > Abstract > > Friday, 30 May 2008 > Mir MC, Planas J, Raventos CX, de IM, Trilla E, Cecchini L, Orsola A, > Morote J.> Departments of Urology and Pathological Anatomy, Vall d’Hebron Hospital, > Autonoma University School > of Medicine, Barcelona, Spain. > > To review the relationship between the Gleason grade and prostate volume in > biopsy and radical > prostatectomy (RP) specimens, and thus assess the hypothesis that smaller > prostates have a greater > incidence of high-grade tumours.> > We selected 390 patients who had RP at our institution, with a > prostate-specific antigen (PSA) level of > <10 ng/mL and who had not had hormonal therapy. We retrospectively reviewed > the data for transrectal > ultrasonography (TRUS)-guided prostate biopsies from these patients and the > RP specimens. Indications > for biopsy included a PSA level of >/=4 ng/mL or an abnormal digital rectal > examination. High-grade > tumours were defined as having a Gleason score of >/=7.> > The TRUS volume was statistically related to the rate of high-grade tumours > at biopsy and RP. On > multivariate analyses, TRUS volume was a significant predictor of high-grade > tumour for biopsy and RP > specimens, with an inverse relationship between high-grade tumours and > prostate volume for biopsy and > RP specimens.> > Our data suggest that there is a relationship between the rate of high-grade > tumours and prostate volume > even in biopsy and RP specimens and it is not an artefact related to the > biopsy.> > Reference BJU Int. 2008 May 12. Epub ahead of print. > doi:10.1111/j.1464-410X.2008.07696.x> PubMed Abstract PMID:18476971> UroToday.com Prostate Cancer Section> > > > **************Get trade secrets for amazing burgers. Watch "Cooking with > Tyler Florence" on AOL Food. > (http://food.aol.com/tyler-florence?video=4 & ?NCID=aolfod00030000000002)>