PROSTATE CANCER: BEWARE OF EXTREMES
One of the first lessons a doctor learns in medical school is that, “There are always two things you never say—always and never.” The truth is probably somewhere in the middle.
For many years at Johns Hopkins, the approach was that if a man had cancer found at a TUR but not a tumor large enough to be felt in a digital rectal exam (men with stage Ti or A cancer), then his cancer was the incidental kind, with “low malignant potential” and not much clinical significance—the kind of cancer men die “with,” not “of.” And so they weren’t treated.
In 1976, Johns Hopkins investigators embarked on a pioneering study using tumor volume to predict cancer patients’ prognosis. They analyzed the medical histories of more than 100 of these men who were not treated, and they followed their progress for an average of seven years. Their findings: One group of these men did reasonably well; their cancer rarely progressed. But another group did not fare so well; their cancer continued to grow.
What was the difference between these two groups? The clue, investigators found, was in the percentage of cancer found in tissue removed during the TUR. (This work provided the now-standard classifications for stage Ti disease.)
*88\201\8*
Leave a reply
You must be logged in to post a comment.