Rethink the risk of prostate cancer in GG1 diagnoses

A new study reveals that some men who are diagnosed with prostate cancer of “group 1 of grade” (GG1) can in fact be more at risk than the results of biopsy suggest. Meanwhile, according to research led by Weill Cornell Medicine, University HospitalS Cleveland and Case Western University. Meanwhile, Researchers conclude that relying on the grade of biopsy alone can lead to an underestimation of the risk of illness. In addition, a poorly classical classification which can benefit from final treatment with surgery or radiotherapy. For example, Biopsies only test small prostate areas. For example, so that they can miss more advanced or aggressive cancer cells, offering an incomplete image.

The study. However, published on July 31 in the journal Jama Oncology, revealed that a in six man with cancer in the rethink risk prostate cancer gg1 GG1 category is turned out to have intermediate or high -risk cancer when other clinical characteristics are considered in addition to biopsy results. Meanwhile, “We do not want to lack aggressive cancers which initially present themselves as the first group on biopsy. Meanwhile, ” said Co-Sensior Author Dr Bashir Al Hussein, deputy professor of urology and population sciences at Weill Cornell Medicine. Additionally, Meanwhile, “Such an underestimation of the risk could lead to subcontracting and poor results. However, »»

The results of the study could also shed light on recent discussions on the opportunity to completely remove. Consequently, the cancer label for GG1 tumors.

There is a misunderstanding that “low grade” and “low risk” are the same. Furthermore, Here we clearly show that they are not. Consequently, GG1 renowned attempts are wrong because many patients with GG1 cancer on biopsy have substantial risks of their cancers causing pain. Similarly, rethink risk prostate cancer gg1 suffering during their lifetime if they are not treated. “”

Dr Jonathan Shoag, co-ennior author, Associate Professor of Urology at Case Western Reserve University and Urologist in Cleveland University Hospitals

Precisely categorize the guides of tumors

Rethink risk prostate cancer gg1

The team relied on the data collected between 2010 and 2020 by the program of surveillance, epidemiology and end results of the National Cancer Institute. Furthermore, “These are contemporary data in the real world representing all men diagnosed with prostate cancer in the United States. ” said Dr. Al Hussein. who is also an urologist at the New York-Presbyterian / Weill Cornell Medical Center and member of the Sandra and Edward Meyer Cancer Center at Weill Cornell Medicine. The data included around 300,000 men diagnosed with cancer located in the prostate.

About 117,000 of these men had a biopsy rethink risk prostate cancer gg1 which was classified as GG1. This grade is often used synonymous with a low risk of progression to metastases. cancer spreading to other parts of the body. They are generally followed by active monitoring tests – to monitor a protein produced by prostate. additional biopsies and MRI analyzes. The increase in specific prostate antigen levels (PSA) in the blood may indicate the progression of cancer.

But what happens if some of these men host more aggressive prostate cancers suggested by their biopsy note alone? Dr. Al Hussein. his colleagues also analyzed individuals in the GG1 group with their clinical data such as PSA levels and tumor size. When all the data were taken into account. the researchers discovered that more than 18,000 of these men had higher risk cancers who are often treated with radiotherapy or prostate elimination (radical prostatectomy).

“Our data shows that up to 30% of patients rethink risk prostate cancer gg1 diagnosed with GG1 but who were in the higher risk category underwent active monitoring. which means that they were potentially subcontracted,” said Dr. Al Hussein.

What is in a name

Understanding how cancer classification is correlated with clinical results is particularly critical. as some doctors recommend removing the GG1 prostate cancer “cancer” label, which could reduce anxiety and useless treatment. They argue that most of the tumors classified as GG1 develop slowly and rarely spread or cause damage. However, the document advises that a single approach is risky.

“There was an unfortunate confusion of several different terms of some of my colleagues who try to rename GG1 cancer. ” said Dr. Shoag. “One is that the GG1 biopsy and the GG1 prostatectomy are similar, but they are not. As clinicians, we must make decisions based on each patient and his biopsy translates into this context. The data suggesting that GG1 rethink risk prostate cancer gg1 cancers do not spread are largely based on previous studies on prostatectomy samples. which have examined the whole prostate once deleted.

“A subset of men with low-grade tumors has unfavorable clinical characteristics that are associated with worst cancer results. We must better understand this biology, which could help clinicians improve the prognosis, “said the first author, Dr. Neal Arvind Patel, deputy professor of clinical urology, a urologist at the New York Cancer Center.

Dr. Al Hussein also sees room to improve the way patients are advised. “We have to find a better way to inform patients of their prognosis when they have GG1 prostate cancer with unfavorable clinical characteristics. ” he said. Moreover, “As doctors. the responsibility is responsible for educating patients and providing them with the information they need to understand their diagnosis and decide on the best approach for treatment, while continuing to plead for active monitoring of rethink risk prostate cancer gg1 those who are indeed at low risk. »»

This research is supported by Frederick J. and Theresa Dow Wallace Fund from the New York Community Trust.