(Press-News.org) Even in the presence of screening, there is benefit to radical prostatectomy (RP) in prostate cancer patients, however, the benefit is limited to a subgroup of patients and can take years to become evident according to a study published February 14 in the Journal of the National Cancer Institute.
The Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4) trial identified that RP lowered prostate cancer deaths with a statistically significant absolute mortality difference (AMD) between RP and watchful waiting (WW) of 6.1%. The Prostate Cancer Intervention Versus Observation Trail (PIVOT) recently published results from a US-based trial comparing the effectiveness of RP compared with watchful waiting (WW). The PIVOT trial found a non-statistically significant reduction in the risk of prostate cancer death in the RP group with an absolute risk reduction of 3% after a 12-year follow-up. Although these findings may seem inconsistent with the results from the Scandinavian trial, it is unknown if more frequent screen detection in PIVOT can explain the lower AMD.
In order to determine if a more frequent screen detection in PIVOT explains the lower AMD when compared to the SPCG-4 trial, Jing Xia, Ph.D., of the Fred Hutchinson Cancer Research Center in Seattle and colleagues, assumed that the SPCG-4 trial represented RP efficacy and prostate cancer survival in an unscreened population. They then adjusted prostate cancer survival using published estimates of overdiagnosis and lead time to evaluate the effect of screen detection on disease-specific deaths and the observed AMD.
The researchers found that overdiagnosis and lead time explains the lower AMD in PIVOT if the RP efficacy and prostate cancer survival in the absence of screening are comparable to that of the SPCG-4 trial. They conclude that if these findings are the correct explanation, then a specific set of cases should not be treated with RP and that their identification should lead to a better understanding of the RP benefit in the remaining cases. "PIVOT should not be interpreted as evidence that RP is not efficacious in reducing prostate cancer mortality," the researchers write. "PIVOT should encourage us to develop tests to identify cases for which immediate treatment is beneficial."
###
Contact Info: Ruth Etzioni, Ph.D., retzioni@fhcrc.org
The role of radical prostatectomy in patients with prostate cancer
2013-02-15
ELSE PRESS RELEASES FROM THIS DATE:
The human pathogen Streptococcus pneumonia shields foreign DNA derived from other bacteria to promote genetic diversity and vaccine evasion
2013-02-15
FINANCIAL DISCLOSURE: CJ was funded by a grant from the Agence Nationale de la Recherche (projet n_ BLAN06-3_141806). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
COMPETING INTEREST: The authors have declared that no competing interests exist.
PLEASE ADD THIS LINK TO THE PUBLISHED ARTICLE IN ONLINE VERSIONS OF YOUR REPORT:
http://dx.plos.org/10.1371/journal.ppat.1003178
(link will go live upon embargo lift)
CITATION: Johnston C, Martin B, Granadel C, Polard P, Claverys J-P (2013) Programmed ...
Study shows alcohol consumption is a leading preventable cause of cancer death in the US
2013-02-15
(Boston) – Researchers from the Boston University School of Medicine (BUSM) and Boston University School of Public Health (BUSPH) have shown that alcohol is a major contributor to cancer deaths and years of potential life lost. These findings, published in the April 2013 issue of the American Journal of Public Health, also show that reducing alcohol consumption is an important cancer prevention strategy as alcohol is a known carcinogen even when consumed in small quantities.
Previous studies consistently have shown that alcohol consumption is a significant risk factor ...
Johns Hopkins researchers create new air sacs in mouse model of emphysema using novel growth factor
2013-02-15
In a study of mice, researchers at Johns Hopkins have identified a new molecular pathway involved in the growth of tiny air sacs called alveoli that are crucial for breathing. The scientists say their experiments may lead to the first successful treatments to regrow the air sacs in people who suffer from diseases such as emphysema in which the air sacs have been destroyed by years of smoking. The work may also suggest new therapy for premature infants born before their lungs are fully developed.
"One of the most daunting challenges we face as physicians is helping patients ...
U of M researchers find that doula care for low-income women could save taxpayers money
2013-02-15
MINNEAPOLIS / ST. PAUL (EMBARGOED UNTIL February 14, 2013) – New research from the University of Minnesota's School of Public Health has found lower cesarean birth rates among Medicaid beneficiaries with access to support from a birth doula than among Medicaid patients nationally. A doula is not a medical provider, but is a trained, experienced professional person who can provide information, physical assistance and support to a woman during childbirth.
The research indicates that policy changes to provide Medicaid coverage for birth doulas may actually decrease costs ...
X-ray laser sees photosynthesis in action
2013-02-15
Opening a new window on the way plants generate the oxygen we breathe, researchers used an X-ray laser at the Department of Energy's (DOE) SLAC National Accelerator Laboratory to simultaneously look at the structure and chemical behavior of a natural catalyst involved in photosynthesis for the first time.
The work, made possible by the ultrafast, ultrabright X-ray pulses at SLAC's Linac Coherent Light Source (LCLS), is a breakthrough in studying atomic-scale transformations in photosynthesis and other biological and industrial processes that depend on catalysts, which ...
Combo of Avastin, second drug shows promise fighting brain cancer, Mayo Clinic finds
2013-02-15
JACKSONVILLE, Fla. — The drug bevacizumab, also known by the trade name Avastin, shrinks tumors briefly in patients with an aggressive brain cancer known as glioblastoma multiforme, but then they often grow again and spread throughout the brain for reasons no one previously has understood. Now, Mayo Clinic researchers have found out why this happens. They have also discovered that pairing Avastin with another cancer drug, dasatinib, can stop that lethal spread. Dasatinib is approved for use in several blood cancers.
The findings, based on an animal study, are detailed ...
Scientists develop improved fire management tools for Africa's savannas
2013-02-15
DAKAR, SENEGAL (15 February 2013)—Scientists at the Nairobi-based World Agroforestry Centre (ICRAF) and partners have developed specialized graphs that map out fire behavior, known as nomographs, for landscape managers in Africa's savannas. The study, published in the February issue of the Journal of Arid Environments, pinpoints the optimal conditions for setting early-season prescribed fires—a process that when executed and timed properly, reduces the risk and impact of late dry season bushfires in increasingly fragile ecosystems, both of which are exacerbated by climate ...
Humans and chimps share genetic strategy in battle against pathogens
2013-02-15
A genome-wide analysis searching for evidence of long-lived balancing selection—where the evolutionary process acts not to select the single best adaptation but to maintain genetic variation in a population—has uncovered at least six regions of the genome where humans and chimpanzees share the same combination of genetic variants.
The finding, to be published Feb. 14 in the journal Science, suggests that in these regions, human genetic variation dates back to a common ancestor with chimpanzees millions of years ago, before the species split. It also highlights the importance ...
Smoking bans linked with 'successive reductions' in preterm birth
2013-02-15
The study supports the notion that smoking bans have public health benefits from early life.
It is well established that smoking during pregnancy impairs the growth of an unborn child and shortens gestation. Exposure to second-hand smoke has also been found to affect birth outcomes, yet little is known about the impact of recent smoke-free legislation on birth weight and preterm birth.
So a team of researchers, lead by Dr Tim Nawrot from Hasselt University, investigated whether recent smoking bans in Belgium were followed by changes in preterm delivery. In Belgium, ...
Study finds strong link between income inequality and readmission risk, but not mortality
2013-02-15
The authors estimate nearly 40,000 extra admissions to hospital as a result of income inequality over the three year study period.
Income inequality is associated with a variety of adverse health outcomes, including higher infant mortality, reduced life expectancy, and poorer self-reported health. But little is known about the possible link between income inequality and outcome after admission to acute care hospitals.
So a team of US researchers examined the association between income inequality and risk of death and readmission within 30 days of discharge from hospital. ...