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PSA, Alkaline Phosphatase Predict Prostate Cancer Survival

After six months of hormone treatment, values are better predictors than baseline prostate specific antigen

THURSDAY, Dec. 27 (HealthDay News) -- For men with metastatic prostate cancer undergoing hormone treatment, measurements of alkaline phosphatase (ALP) at the start of treatment and measurement of ALP and prostate specific antigen (PSA) after 6 months, are better predictors of survival than baseline PSA, according to research published in the January issue of the Journal of Urology.

David Robinson, M.D., of Ryhov County Hospital in Jonkoping, Sweden, and colleagues analyzed data on 697 men with metastatic prostate carcinoma enrolled in a study comparing parenteral estrogen with total androgen blockade. PSA (a marker of tumor burden) and ALP (a marker of skeletal involvement) were measured before treatment, after one and three months, and every three months after.

Of the six prognostic factors they tested, based on PSA and ALP levels, the three best variables for predicting outcome were ALP at six months, ALP at baseline, and PSA at six months. According to the authors, changes in ALP and PSA measurements during the first six months of hormone treatment reflects how well patients are responding to the treatment.

"We recommend that the ALP level after six months of treatment is included in the follow-up of every patient where prognostic information is required. The interpretation of normalization of ALP after six months is that the treatment has been effective and that the tumor activity in the skeleton is low, which in turn implies longer survival," the authors write.

The study was supported by several pharmaceutical companies.

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