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Prostate Cancer Diagnosis: Understanding Gleason Score and Disease Staging

New York, NY, Aug. 22, 2013 (GLOBE NEWSWIRE) -- A newly published prostate cancer study helps clarify the risk associated with watchful waiting and active surveillance. Researchers found that as prostate-specific antigen (PSA) testing became more widespread, late-stage prostate cancer diagnoses plummeted, but Gleason scores did not. Their findings suggest that men who choose not to treat their prostate cancer face greater danger of disease spread than disease strengthening.

Over the course of a 20-year data window (1982-2004), incidence of prostate-specific antigen (PSA) testing increased from 42 percent to 81 percent. During that time, late-stage prostate cancer diagnoses dropped 85 percent, but Gleason score declined a moderate 30 percent. Dr. David Samadi, expert robotic prostate surgeon and Chairman of Urology, Chief of Robotic Surgery at Lenox Hill Hospital and Professor of Urology at Hofstra North Shore-LIJ School of Medicine, explains the difference between prostate cancer staging and Gleason score.

"Prostate cancer staging is used to quantify disease spread within or beyond the prostate. Gleason score defines the cancer's aggressiveness or grade. Using PSA test results and biopsies, we attempt to define a man's overall disease as best we can," said Dr. Samadi.

Prostate cancer diagnosis can be challenging. The PSA test detects spikes in prostate-specific antigen levels that can indicate the presence of cancer. A prostate biopsy gives more data about disease characteristics, but experts admit it can be difficult to paint a complete picture.

"While data suggests untreated prostate cancer may not become more aggressive, it doesn't mean it will stay put," explains Dr. Samadi. "Left alone, prostate cancer is very likely to spread beyond the prostate. Robotic prostate surgery mitigates that risk by completely removing the cancerous prostate. If you wait till the cancer spreads, the opportunity for cure may be lost."

Post-surgery testing of the prostate tumor is currently the only definitive means for establishing a Gleason grade. In fact, in as many as 40 percent of cases, post-surgery analysis reveals a man's prostate cancer to be more aggressive than indicated by pre-surgery biopsy.

"Interestingly, it was surgery that afforded the data needed for this study," added Dr. Samadi. "Without post-surgery tumor analysis, we don't know the true extent of a man's prostate cancer."

The study appears in the August 15 journal of the American Association for Cancer Research, Cancer Research, http://cancerres.aacrjournals.org/content/73/16/5163.

Dr. Samadi and his team of prostate cancer experts help men and their families make the most informed treatment decisions at the Lenox Hill Hospital Prostate Cancer Center in New York.

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* The benefits of robotic surgery cannot be guaranteed as surgery is both patient and procedure specific. Previous surgical results do not guarantee future outcomes.
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D. McGuire, Suffern, New York

"In full recognition of my panicked state his office made arrangements for my wife and I to meet with him that same day. We knew immediately we found who we were looking for..."

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Guy, G

I learned in November 2012 following a high blood PSA value and prostate biopsy, that I had prostate cancer. It has a Gleason 7+ value, which placed it in a the problem category needing a rapid care...

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John, New York,USA

My urologist then referred me to Dr. David Samadi, Chief of Robotics and Minimally Invasive Surgery at Mt. Sinai Hospital, specializing in urological oncology, robotic surgery, and development of the Da Vinci technique. He had performed over 1500 surgeries successfully.

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"Just yesterday I got the results of my one month post surgery blood test, the PSA level is less than 0.1, thank you Dr. Samadi!"

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