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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.



Testimonials
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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Mark E. Russia

I was discharged from the hospital the day after surgery and my catheter was removed in four days. A month and a half after the surgery, I took a two week car trip to Canada by myself. Two years after the surgery I married a wonderful woman and we are living a happy life together...

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Yossi, Israel

I chose to undergo the operation with a specialist in the U.S., who has an extensive experience in robotic surgeries: Dr. David Smadi. The surgery was relatively simple: i didn't suffer any pain, lost a small amount of blood and had the catheter only for seven days. I got back to full functioning very soon afterwards.

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Rob

It has been nearly two weeks since Dr. Samadi performed my SMART prostatectomy!  Every day since the surgery  Dr. Samadi and his skill as a surgeon have soared in my estimation. I feel humbled and privileged to have experienced such great care.

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