The aggressiveness of a prostate cancer tumor -- meaning how fast it's spreading, and how far it's spread -- might not change with time, at least for some men, according to a new study.


The findings add weight to the "active surveillance" route[1] some patients choose to take, where their prostate cancer tumors are monitored over time to ensure they don't grow or spread -- but no treatment is actually administered.


Men who have a low-grade tumor -- where the cells on the tumor still look more like normal prostate tissue -- may talk with their doctor and opt for active surveillance by following up with the "tumor over time and seeing what happens. We think the results [of this study] can make men feel more comfortable with the decision that they have made," study researcher Kathryn Penney, Sc.D., an instructor in medicine at Harvard Medical School and associate epidemiologist at the Channing Division of Network Medicine at Brigham and Women's Hospital, told HuffPost.


The study, published in the journal Cancer Research[2] , involved analysis of prostate tissue from 420 people who were part of the Physicians' Health Study and 787 people who were part of the Health Professionals Follow-Up Study. All of the people in the study had been diagnosed with prostate cancer sometime between 1982 and 2004, and had their disease treated with surgery.


Researchers divided up the study participants' data into four time periods within 1982 to 2004; they did this in order to capture the increases in prostate-specific antigen (PSA) testing[3] throughout time (for instance, PSA testing for prostate cancer increased from 42 percent to 81 percent between 1994 and 2000).


"Over time, because of PSA screening, men have been more likely to be diagnosed with prostate cancer at an earlier stage, before the disease has had an opportunity to grow and spread[4] . If Gleason grade also progressed over time, we would expect a similar decrease in high Gleason grade disease over time," Penney said in a statement.


Researchers found that over that time period, the proportion of people diagnosed with advanced-stage prostate cancer decreased from 19.9 percent from 1982-1993 to 3 percent in 2000-2004. (Cancer stages refer specifically to how much a tumor has spread, and if it has spread outside of the prostate to other parts of the body.)



However, over that same time period, they didn't find a huge drop in the proportion of prostate cancer patients diagnosed with high-grade tumors, with the percentage only decreasing from 25.3 percent in 1982-1993 to 17.6 percent in 2000-2004. (Tumor grades, or Gleason grades, are indicative of the aggressiveness of a prostate cancer tumor. They are determined by looking at an actual sample of the tumor, either after a biopsy, or after a radical prostatectomy, where the prostate is removed.)


"We were surprised by just how constant the incidence of high-grade disease has been over time," Penney said in the statement.



Also on HuffPost:




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  • New Advice On Prostate Cancer Screening


    This year, the U.S. Preventive Services Task Force <a href="http://www.npr.org/blogs/health/2012/05/21/153234671/all-routine-psa-tests-for-prostate-cancer-should-end-task-force-says">recommended <em>against</em> routine prostate cancer screening</a> for men of all ages, noting its small benefits compared to the harms, published in the <em>Annals of Internal Medicine</em>. "We think the <a href="http://www.npr.org/blogs/health/2012/05/21/153234671/all-routine-psa-tests-for-prostate-cancer-should-end-task-force-says">benefit is very small</a>," Dr. Michael LeFevre, a member of the task force, told NPR's Shots blog. "Our range is between zero and one prostate cancer death avoided for every thousand men screened," which is minuscule compared to lives saved for screenings for conditions like colorectal cancer. A study published at the beginning of the year in the <em>Journal of the National Cancer Institute</em> seemed to back up the recommendations, noting that routine prostate cancer screening didn't seem to make a <a href="http://www.huffingtonpost.com/2012/01/06/prostate-cancer-screening-psa-test-deaths-men_n_1190558.html">difference in the risk of dying from prostate cancer</a>, Reuters reported. However, the American Society of Clinical Oncology issued advice after the USPSTF's recommendation, saying that whether a man gets routine prostate cancer screening should <a href="http://www.huffingtonpost.com/2012/07/17/prostate-cancer-screening-test-man-life-expectancy_n_1679499.html">depend on his life expectancy</a>. For example, men who aren't expected to live more than another 10 years should be discouraged from PSA testing, the Associated Press reported.




  • PSA Testing Could Mean Fewer Cases Of Deadly Prostate Cancer


    To add more to the research on prostate cancer screening, a study in the journal <em>Cancer</em> showed that routine PSA testing is linked with 17,000 fewer cases of the deadliest form of prostate cancer. "By not <a href="http://www.webmd.com/prostate-cancer/news/20120730/study-psa-testing-cuts-worst-prostate-cancers">using PSA tests</a> in the vast majority of men, you have to accept you are going to increase very serious metastatic disease threefold," study researcher Dr. Edward Messing, M.D., the chief of urology at the University of Rochester Medical Center, told WebMD. Specifically, researchers calculated that without routine prostate cancer screenings through PSA testing, 25,000 men would have been diagnosed with <a href="http://www.webmd.com/prostate-cancer/news/20120730/study-psa-testing-cuts-worst-prostate-cancers">metastatic prostate cancer</a> (a deadly form of prostate cancer where it has spread beyond the prostate to elsewhere in the body) in 2008, compared with the 8,000 who were actually diagnosed with metastatic prostate cancer that year, WebMD reported.




  • Working The Night Shift Could Raise Your Risk


    <a href="http://www.huffingtonpost.com/2012/10/25/night-shift-prostate-cancer-health_n_2003392.html">Working the night shift</a> is associated with a 2.77-times increased risk of prostate cancer, according to a study in the <em>American Journal of Epidemiology</em>. The study, conducted by Canadian researchers included 3,137 men with cancer and 512 men without cancer. The researchers also found that <a href="http://www.huffingtonpost.com/2012/10/25/night-shift-prostate-cancer-health_n_2003392.html">working the night shift</a> raised the risk of lung, colon, bladder, rectal and pancreatic cancers, as well as non-Hodgkin's lymphoma.




  • Surgery May Not Be The Best Option For Everyone With Prostate Cancer


    Surgery may not always be the best option for men whose prostate cancer is detected with an elevated PSA (prostate-specific antigen) level, according to a study in the <em>New England Journal of Medicine</em>. For men with early prostate cancer who received a <a href="http://abcnews.go.com/Health/ProstateCancer/surgery-rarely-best-prostate-cancer-study-suggests/story?id=16805902#.UJrg9m_A_kh">radical prostatectomy</a> (prostate-removal surgery), 47 percent died after 12 years, while 49.9 percent of men who just underwent observation died after 12 years, ABC News reported. Plus 81 percent of men who underwent the radical prostatectomy <a href="http://www.webmd.com/prostate-cancer/news/20120718/prostate-cancer-surgery-may-not-always-up-survival">experienced erectile dysfunction</a> in the two years following, and urinary incontinence plagued 17 percent of the men, WebMD reported. However, ABC News did note that men whose <a href="http://abcnews.go.com/Health/ProstateCancer/surgery-rarely-best-prostate-cancer-study-suggests/story?id=16805902#.UJrg9m_A_kh">PSA scores were extremely high</a> -- above 10 -- benefited from receiving surgery, indicating that the study may suggest rather <em>which</em> men may benefit most from receiving a radical prostatectomy for their prostate cancer.




  • Aspirin Could Help Prostate Cancer Patients Live Longer


    Prostate cancer patients who <a href="http://www.nytimes.com/2012/08/28/health/research/regular-aspirin-use-may-aid-prostate-cancer-recovery-study-finds.html">take aspirin</a> could cut their risk of dying from the disease, Harvard researchers reported this year. <em>The New York Times</em> reported on the study, published in the <em>Journal of Clinical Oncology</em>, which showed that taking aspirin cut in half the risk of <a href="http://www.nytimes.com/2012/08/28/health/research/regular-aspirin-use-may-aid-prostate-cancer-recovery-study-finds.html">dying of prostate cancer</a> over a decade -- 8 percent of aspirin-nontakers died, compared with 3 percent of aspirin-takers.




  • Circumcision Could Affect Risk


    Circumcision -- or the removal of a man's foreskin before he has sex for the first time -- is linked with a <a href="http://www.huffingtonpost.com/2012/03/12/circumcision-prostrate-cancer_n_1339047.html">lower risk of developing prostate cancer</a>, Fred Hutchinson Cancer Research Center scientists found this year. The findings, published in the journal <em>Cancer</em>, shows that prostate cancer risk for <a href="http://www.huffingtonpost.com/2012/03/12/circumcision-prostrate-cancer_n_1339047.html">men who are circumcised</a> before the first time they have sex is 15 percent lower, compared with uncircumcised men. While Dr. Andrew Freedman, who is on the American Academy of Pediatrics' circumcision task force but was not involved in the study, found the findings thought-provoking, he told HuffPost in an earlier article that "this kind of epidemiological research -- how A affects B, and B affects C -- is very difficult to do and makes it very difficult to account for confounding variables."




  • Pan-Fried Meat Could Raise Risk


    Including <a href="http://www.huffingtonpost.com/2012/08/20/pan-fried-meat-cancer-prostate-_n_1798970.html">pan-fried meat</a> in your weekly meal rotations is linked with a higher risk of prostate cancer, University of Southern California researchers found. Specifically, men who eat one-and-a-half servings of red meat that's been pan-fried each week have a 30 percent <a href="http://www.huffingtonpost.com/2012/08/20/pan-fried-meat-cancer-prostate-_n_1798970.html">increased risk of advanced prostate cancer</a>. And men who eat two-and-a-half servings of the food have a 40 percent increased risk. Hamburger meat in particular -- compared with a red meat like steak -- seemed linked with the increased risk, according to the <em>Carcinogenesis</em> study. And while not a red meat, pan-fried poultry also seemed linked with the <a href="http://www.huffingtonpost.com/2012/08/20/pan-fried-meat-cancer-prostate-_n_1798970.html">increased prostate cancer risk</a> (while <em>baked</em> poultry was associated with a lower prostate cancer risk).




  • Genetic 'Signatures' Could Predict Aggressive Disease


    Genes could hold a clue to who will go on to <a href="http://www.huffingtonpost.com/2012/10/09/prostate-cancer-genetic-signatures-aggressive-tumors_n_1949724.html">develop aggressive prostate cancer</a>, researchers found this year. Reuters reported on the <em>Lancet Oncology</em> study, showing aggressive tumors might be able to be predicted by two <a href="http://www.huffingtonpost.com/2012/10/09/prostate-cancer-genetic-signatures-aggressive-tumors_n_1949724.html">genetic "signatures</a>": <blockquote>Researchers in Britain and the United States found that by reading the patterns of genes switched on and off in blood cells, they could accurately detect which advanced prostate cancer patients had the worst survival rates.</blockquote>




  • Blood Pressure Could Affect Risk Of Dying From Prostate Cancer


    The risk of dying from prostate cancer is higher if you also<a href="http://www.huffingtonpost.co.uk/2012/10/23/blood-pressure-prostate-cancer-deaths_n_2004582.html?just_reloaded=1"> have high blood pressure</a>, European researchers found. Specifically, hypertension was linked with a 62 percent increased risk of dying for people with prostate cancer. "When we looked to see if the metabolic factors are related to an increased risk of getting or dying from prostate cancer we found a relationship with <a href="http://www.huffingtonpost.co.uk/2012/10/23/blood-pressure-prostate-cancer-deaths_n_2004582.html?just_reloaded=1">death from the disease and high blood pressure</a>," study researcher Christel Haggstrom, of Umea University, told HuffPost UK. "There was also a link to high BMI but blood pressure had the strongest association to increased risk. The results for BMI are in line with previous findings in large studies."




  • Green Tea Is Good


    Research presented at the annual meeting of the American Association for Cancer Research this year showed that drinking green tea could <a href="http://www.eurekalert.org/pub_releases/2012-10/aafc-gtr101112.php">help ward off inflammation</a> in men with prostate cancer who are about to undergo prostate-removal surgery. "Our study showed that <a href="http://www.eurekalert.org/pub_releases/2012-10/aafc-gtr101112.php">drinking six cups of green tea</a> affected biomarkers in prostate tissue at the time of surgery," study researcher Susanne M. Henning, Ph.D., R.D., of the David Geffen School of Medicine at the University of California Los Angeles, said in a statement. "This research offers new insights into the mechanisms by which green tea consumption may reduce the risk for prostate cancer by opposing processes such as inflammation, which are associated with prostate cancer growth."