July 25, 2014
 
prostate cancer discovery  
   THE BRADY UROLOGICAL INSTITUTE • JOHNS HOPKINS MEDICINE

   A PUBLICATION OF THE PATRICK C . WALSH PROSTATE CANCER RESEARCH FUND
   Volume V, Winter 2009


  Study:
  Men with Gleason 6 or Lower: Prognosis Is Excellent
 

   
 

Because PSA screening is becoming widespread, many men are diagnosed with prostate cancer years earlier than they would have been 20 years ago — when diagnosis usually depended on a suspicious lump being found in a rectal exam. Most men are diagnosed with organ-confined cancer (stage T2) and a Gleason score of 6 or lower.

“These men have an excellent prognosis,” says Patrick C. Walsh, M.D., University Distinguished Service Professor of Urology. Recently, Walsh and colleagues David Hernandez, Matthew Nielsen, Misop Han, Bruce Trock, Alan Partin, and Jonathan Epstein looked at 2,526 men who underwent radical prostatectomy at Johns Hopkins between 1983 and 2005, who had organ-confined disease and a Gleason score of 6 or lower.

“ If you are a man diagnosed with organ-confined disease and a Gleason grade of 6 or lower, and you undergo radical prostatectomy, your changes of having an undetectable PSA in 10 years are 99.1 percent.”

At an average follow-up of five years, fewer than one percent (13 men) had a detectable PSA, and at 15 years after surgery, only 1.3 percent had a detectable PSA. Five patients developed a local recurrence of cancer; four of these underwent salvage radiation therapy,and after this had an undetectable PSA. None of the men had a distant metastasis, and no one died of prostate cancer.
“If you are a man diagnosed with organ-confined disease and a Gleason grade of 6 or lower, and you undergo radical prostatectomy,your changes of having an undetectable PSA in 10 years are 99.1 percent,” says Walsh.

   


 

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