Entries in Prostate Cancer (35)


Salad Dressing May Increase Likelihood of Surviving Prostate Cancer

iStockphoto/Thinkstock(NEW YORK) -- New research shows that a spoonful of salad dressing my dramatically increase a man's survival chances after he has been diagnosed with prostate cancer.

The study, which looked at nearly 4,600 patients who had been diagnosed with prostate cancer that had not spread to any other part of their bodies. Researchers found that one serving -- approximately one tablespoon -- of oil-based dressing per day led to a 29 percent lower risk dying of prostate cancer and a 13 percent lower risk of dying from any cause.

The researchers concluded that replacing animal fats and carbohydrates with vegetable fats like olive oil and canola oil worked against disease progression and death due to an increase in antioxidants and reduced inflammation.

The study also revealed significant results from eating one ounce of nuts per day.

Nearly 2.5 million men live with prostate cancer in the United States.

Copyright 2013 ABC News Radio


Exercise Linked to Lower Prostate Cancer Risk

iStockphoto/Thinkstock(NEW YORK) -- Men who want to avoid prostate cancer should start working out. New research suggests a link between exercise and a lower risk for the disease.
Prostate cancer is second only to skin cancer as the most common form of the disease in American men.
The American Cancer Society estimates that nearly 239,000 cases of prostate cancer, which occurs mainly in older men, will be diagnosed this year.
A study published in the journal Cancer looked at the exercise habits of 307 men aged 62 to 71.
When the study participants underwent prostate biopsies, doctors found that the Caucasian men who were moderately active were less likely to have a positive prostate biopsy result. And those who did have a positive biopsy were less likely to have a high-grade cancer than those who were sedentary.
But, the study authors reported, increased exercise did not reduce the prostate cancer risk in black men.
Copyright 2013 ABC News Radio


Prostate Cancer: Surgery Rarely Best, Researcher Suggests

iStockphoto/Thinkstock(NEW YORK) -- Robert Ginyard is a 49-year-old small business owner from Baltimore. He started having prostate-specific antigen (PSA) testing earlier than most -- age 40 -- because his father had been diagnosed with prostate cancer when he was in his 40s. When, at age 47, his PSA went from 4.8 to 7.1 he was referred to see a urologist. His biopsy showed cancer.

And then there's Eddie Carrillo, 67, a contractor from Los Angeles. He saw his doctor when he was 53 for abdominal discomfort and had a PSA of 7. His biopsy also showed cancer.

Ginyard said he discussed his options at length with his wife and two daughters. Ultimately he opted for surgery. After six months of difficulty with urinary continence and sexual performance, he found himself cancer-free and with no difficulties. He says he is "100 percent satisfied" with his decision to remove his prostate.

Carrillo said he felt pretty healthy, had a number of family members who had side effects from treatment for prostate cancer, and "just didn't like invasive operations." He selected a "watch and wait" approach. For the last 14 years, he has undergone periodic PSA testing and prostate biopsies. He is still feeling healthy, living with prostate cancer. His approach to prostate cancer is "not to be afraid of it. Deal with it, because you can't run from it and it can be lived with."

Two men who opted for very different approaches to basically the same disease.

Now, a new study is stirring the coals as to whether doctors should urge more men to opt for Carrillo's approach and avoid prostate cancer surgery. At stake, potentially, is the health of millions of American men. And not all doctors agree that surgery -- and PSA testing along with it -- should be taken off the table.

The goal of a new study in the New England Journal of Medicine was to see whether observation would be better than surgery for early prostate cancer.

It included 731 men diagnosed with prostate cancer after having high PSA levels. Half of the men were assigned to have surgery, while the other half were assigned to be observed -- with PSA testing every six months and bone scans to look for tumor spread -- every five years.

After 12 years, 47 percent of men assigned to surgery died, compared to 49.9 percent of men assigned to observation -- a difference that was not statistically significant. Meanwhile, more than one in five of the men who underwent surgery had adverse effects from their operation -- though men with very high PSA scores (greater than 10) did have a significant benefit from surgery.

Based on their findings, Dr.Timothy Wilt, lead author on the study, concluded that "observation is a wise and right decision for men with prostate cancer detected by PSA." He said that his study agreed with the recent recommendation by the United States Preventive Services Task Force (USPSTF), which in May 2012 said that PSA should not be tested in men for prostate cancer screening.

Nearly all of the experts contacted by ABC News acknowledged that this study helps identify which patients do not require surgery for their prostate cancer.

However, most of these experts disagreed with the notion that all prostate cancer detected with PSA should simply be observed.

"With early diagnosis and improvements in treatment during the past 20 years, the prostate cancer death rate has decreased by 44 percent in the U.S.," said Northwestern University's Dr. William Catalona, medical director of the Urological Research Foundation and the doctor who developed the PSA test for cancer screening. "This trial should not provide men with another excuse not to get tested or treated for prostate cancer."

"Rather than characterizing the study as showing no benefit from surgery compared to observation, this study provides evidence that surgery will reduce metastasis and death from prostate cancer particularly in men with intermediate or high risk tumors," said Bruce Trock, professor and director of the Division of Epidemiology in the Brady Urological Institute.

Many even felt that the study actually supports testing for PSA.

"This study does not undermine the value of PSA but underscores the importance of proper use of PSA in appropriate populations," said Dr. Phillip Kantoff, professor of medicine at Harvard's Dana Farber Cancer Institute. "The USPSTF fails to distinguish the value of PSA in saving lives from the problem of overtreatment."

While the experts could not agree on how to interpret the findings of this study, they all felt that more research was needed to find better tools to identify which prostate cancers would be slow-growing and harmless -- and which ones could be lethal. Technological advances such as prostate MRI and targeted biopsy are promising options undergoing study.

In the meantime, Ginyard and Carrillo had similar advice for patients who get the news they have prostate cancer.

"Really take time to do your research," Ginyard said. "Make the decision by gathering as much information as you can."

"Make sure you get a second opinion," said Carrillo.

Doctors agreed that this is sound advice.

"Prostate cancer is not a one-size-fits-all disease. It's really a spectrum," said Dr. Martin Sanda, a urologist at Harvard's Beth Israel Deaconess Medical Center.

"The message to patients should be, get tested, have a biopsy if necessary, but be very careful before agreeing to treatment," said Dr. Peter Scardino, chief of surgery at Memorial Sloan-Kettering Cancer Center in New York. "Make sure you have a cancer that really poses a serious risk to your life and health and that the treatment is not worse than the disease."

Copyright 2012 ABC News Radio


New PSA Testing Recommendations Ignites Debate Again

iStockphoto/Thinkstock(NEW YORK) -- Although the United States Preventive Services Task Force (USPSTF) recently recommended against routine screening for prostate cancer for most men, a panel of experts from the American Society for Clinical Oncology (ASCO) says that many men could benefit from regular testing.

The panel of ASCO experts recommended that men with more than 10 years to live discuss with their doctors the risks and benefits of screening and whether they should get their levels of prostate-specific antigen (PSA) tested. A high level of PSA may indicate the presence of cancer. The USPSTF, on the other hand, said back in May that routine PSA screening could lead to false positives, which in turn could mean overdiagnosis and overtreatment.

Treatment for prostate cancer, the task force noted, may cause a number of problems including erectile dysfunction and urinary incontinence.

ASCO, however, agreed with USPSTF that screening is not recommended for men with 10 years or less to live. Additionally, ASCO did not include a specific age recommendation, only life expectancy. Doctors are not required to abide by ASCO or USPSTF guidelines -- they are only recommendations.

"A lot of men that have a long life expectancy would benefit from screening, especially those that will be diagnosed with aggressive forms of prostate cancer," said Dr. Robert Nam, an ASCO panel co-chair and head of genitourinary cancer care at the Sunnybrook Research Institute in Toronto. "Men with aggressive prostate cancer can benefit from early treatment."

Nam added that the ASCO recommendations include talking with health care providers about other factors to take under consideration, including family history.

He also said that the panel agreed with USPSTF's concern about over-treatment, but is urging men who find out they have high PSA levels to learn how significant the results really are before getting treatment.

"The meaning of a result may be entirely different for different people," he said. "For example, the risk is much greater for an African American male with a family history of prostate cancer than it is for a Caucasian male with no family history, even if they have the same PSA score."

The American Cancer Society and the American Urological Association also agree that men should discuss their options with their doctors before undergoing screening.

In response to the USPSTF guidelines, the American Urological Association said men "who are in good health and have a 10-15 year life expectancy should have the choice to be tested and not be discouraged from doing so." The association also said the USPSTF's "blanket statement" should not be applied to at-risk populations, such as African Americans.

ABC News reached out to the USPSTF for a response to the ASCO recommendations, but the task force, a government-funded panel of independent primary care providers tasked with making preventive health recommendations, has not yet responded.

Nam said despite the recommendations, there is no clear answer on how beneficial PSA testing is. The panel based its decisions on a systematic review of studies done by the Agency for Healthcare Research and Quality (AHRQ). The USPSTF also used AHRQ data, but according to Nam, the data were a bit older and a couple of the studies were not very reliable.

Several doctors told ABC News they approach screening with their patients in a way that is more consistent with ASCO's recommendations.

"It's a much more reasonable and balanced approach than the USPSTF," said Dr. Peter Scardino, chief of surgery at Memorial Sloan-Kettering Cancer Center in New York. "The idea that we stop recommending PSA screening altogether is not tenable."

Scardino said some strong studies have found PSA testing led to a reduction in cancer-specific and overall mortality. Other studies, however, have found PSA testing to have no effect on the number of deaths.

Dr. Gerald Andriole, chief of urologic surgery at Washington University School of Medicine in St. Louis, said after discussing the risks and benefits of screening with his patients, many of them still opt for testing.

"They are worried about having prostate cancer and generally would prefer to have the test, knowing it is imperfect, than not getting tested at all. At least it gives them some information on which to make health decisions," he said.

An approach known as active surveillance involves monitoring low-risk cancers, but not treating them.

"Data to date suggest that with this approach we can identify the more aggressive, large cancers and still successfully treat them," said Andriole. "Active surveillance is apt to be better than early treatment with surgery or radiation therapy for many men with low-risk cancers and should lessen overtreatment."

Experts also agree that the development of better testing could someday provide a more definitive answer to questions about whether to perform routine screening.

Copyright 2012 ABC News Radio


Green Tea and Gold to Treat Prostate Cancer?

iStockphoto/Thinkstock(COLUMBIA, Mo.) -- A combination of gold and green tea compounds may be the future of prostate cancer treatments, according to a new mouse study published in the Proceedings of the National Academy of Sciences.

Researchers from the University of Missouri found that a combination of a compound found in green tea leaves and radioactive gold nanoparticles were able to destroy the tumor cells. The tea compound, which was attracted to the cancerous cells, helped to deliver the gold nanoparticles, which killed the cancer cells.

Researchers said large doses of chemotherapy, which sometimes have toxic side effects, are currently used to treat a variety of cancers, but the new treatment would require doses that are “thousands of times” lower than that of chemotherapy. The particles are small enough to destroy the diseased cells, but leave the healthy surrounding tissue and cells intact.

“By combining a natural component in green tea that has an affinity for prostate tumor cells, we have formed gold nanoparticles that have a high uptake in tumor cells,” said Dr. Cathy Cutler, research professor at the MU Research Reactor and co-author of the study. “This formulation of gold nanoparticles, which has shown such tumor cell death at such a low dose in a model of aggressive human prostate cancer indicates it could be effective for aggressive prostate cancer.”

The green tea compound used in the study, known as epigallocatechin-gallate, or EGCg, is an antioxidant that has been shown in prior research to have cancer-fighting properties.

According to the Centers Disease Control and Prevention, more than 200,000 men in the United States were diagnosed with prostate cancer, and more than 28,000 died of the disease in 2008.

There is currently no treatment for aggressive prostate cancer, which is the second leading cause of cancer deaths in men. In less aggressive forms of the disease, physicians inject hundreds of radioactive “seeds” into the prostate to treat the cancer, but the seeds have limited tissue penetration, so it is a treatment best used for early stages of the cancer that is contained in the prostate.

Dr. David Crawford, professor of surgery and radiation oncology at the University of Colorado Health Sciences Center, said the use of nanoparticles for a number of areas in medicine to deliver therapy is “exciting,” and, while early in development, still promising.

But Dr. Derek Raghavan, president of Levine Cancer Institute at Carolinas HealthCare System, called the study “headline hunting” and noted the gap between data and clinical application is “vast.” He said there are years of research needed to ensure the safety and efficacy of the treatment.

“I wish people working in basic labs would stop making these types of promises at such an early stage,” Raghavan said. “They secure brief fame, but it is so disruptive to patients who are fighting for their lives. It also adds confusion when real progress is actually being made.”

Lab animal data only occasionally easily translates into clinical application, but many studies based in animals make lofty promises without much follow-up, Raghavan said.

Nevertheless, the University of Missouri scientists were optimistic in their findings, and said they plan on following up their research in dogs, which they said get a form of the disease very similar to the human form.

Copyright 2012 ABC News Radio


Chong Treats Prostate Cancer With Cannabis

Jason LaVeris/FilmMagic(NEW YORK) -- Actor-comedian Tommy Chong, one-half of the pot-loving pair “Cheech and Chong,” said he’s treating his “slow stage-one” prostate cancer with his favorite plant.

“I’ve got prostate cancer, and I’m treating it with hemp oil, with cannabis,” Chong, 74, told CNN Saturday. “So [legalizing marijuana] means a lot more to me than just being able to smoke a joint without being arrested.”

Chong told the news site that he was diagnosed with the illness about a month ago, but he first experienced symptoms of the cancer about eight years ago while in jail after selling drug paraphernalia.

He no longer smokes marijuana because of “health reasons,” he told CNN, and he consumes the hemp oil at night so he “won’t be woozy all day.”

Cannabis has been approved by the U.S. Food and Drug Administration to relieve symptoms of nausea and vomiting, and to help increase appetite in people with cancer and AIDS, according to the American Cancer Society. The most potent ingredient of medical marijuana is THC. The product comes in the form of an inhaler, pills and oil and it can also be smoked.

There are no other drugs that work as well as cannabis for treating the nausea and anorexia associated with cancer and its treatments, Dr. Donna Seger, associate professor of clinical medicine at Vanderbilt University School of Medicine in Nashville, Tenn., told ABC News in March.

It is unclear whether Chong has undergone chemotherapy or other treatments for the cancer, but treatment of stage 1 prostate cancer, which is only found in the prostate, is often approached by the “watchful waiting” technique, when doctors allow time to pass to see the progression of the disease before they suggest surgery or medical intervention.

At least one doctor believes Chong’s promoting his self-described treatment is a disservice to other men with the disease.

“As a comedian, this is a really funny skit,” said Dr. Leonard G. Gomella, chairman of the department of urology at Thomas Jefferson University in Philadelphia. “As a public figure who can get a forum, it is irresponsible. Had he been suffering from widely metastatic disease with bone pain and other devastations, perhaps there may be a role, but not for early disease.”

Copyright 2012 ABC News Radio


Govt. Panel Scuttles Prostate Cancer Testing Recommendations

iStockphoto/Thinkstock(WASHINGTON) -- The governmental advisory panel tasked with issuing cancer screening guidelines made a final recommendation on the most common form of prostate cancer screening, suggesting it's not needed, regardless of age.

On Monday, the United States Preventive Services Task Force, or USPSTF, put forth this guideline on prostate-specific antigen (PSA) blood tests, which more than 20 million American men get each year. The formal recommendation follows draft guidance the task force issued in October 2011. These guidelines drive the screening decisions of doctors throughout the country.

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The PSA blood test is the traditional way to detect evidence of prostate cancer, which is the most common cancer diagnosed in American men. The National Cancer Institute estimates that in 2012, almost 250,000 new cases and more than 28,000 prostate cancer-related deaths will occur.

The task force maintains that PSA tests do more harm than good. Dr. Michael LeFevre, co-vice chairman of the task force, said the medical procedures arising from the tests could have serious downsides, including blood clots, heart attacks, strokes and possibly death. Other complications include impotence and urinary incontinence.

"Of 1,000 men who are screened, at most one man will avoid a prostate cancer death," LeFevre said. "Two to three will have blood clot, heart attack, stroke or even death from treatment of the prostate cancer. One in 3,000 men screened will die of surgical complications from the treatment."

However, the medical community is split on Monday's recommendation. And most urologists -- the doctors who arguably treat the most cases of prostate disease -- do not agree with the task force's guidelines.

"PSA screening is the only test we have," says Dr. William Catalona, a professor of urology at Northwestern University. "The great majority of doctors who deal with prostate cancer patients believe that the task force underestimated the benefits and overestimated the harm. Perhaps it is because none of the Task Force members were urologists."

"There is no mention of the dramatic decline in the number of men with advanced prostate cancer," says Dr. Patrick Walsh, professor of urology at Johns Hopkins University. "In 1990, 21 percent of men at diagnosis had metastatic prostate cancer to bone. Today it is 4 percent. This is clearly a dramatic effect of PSA testing."

"[The new recommendations] fail to recognize that in the absence of PSA testing, a man will not know that he has the disease until he has symptoms, at which time the cancer is too far advanced to cure," Walsh said.

And Dr. Gerald Andriole, chief of urology at Washington University School of Medicine, called the task force's recommendations "too draconian on categorically dismissing PSA."

"In some respects we have not been using PSA as well as we could," Andriole said. "However, to post a headline that says 'No More PSA Testing' is throwing the baby out with the bathwater."

Primary care physicians differed on whether the recommendations are a good idea. Some, like Dr. Jacques Carter, assistant professor of medicine at Harvard Medical School, insisted that "screening for prostate cancer saves lives." Others, like Dr. Jim Jirjis, director of adult primary care at Vanderbilt University, said they had already begun to recommend against the tests. Still, others said that the decision needed to be made on a case-by-case basis.

"I agree that screening for prostate cancer in men in general is a bad idea," said Dr. John Messmer, associate professor of family and community medicine at Penn State Hershey College of Medicine. "That being said, the possibility of obtaining a PSA on a man with particular circumstances should still be an option."

As for the millions of middle-aged and older men who find themselves in the middle of this debate, the consensus among the physicians is for them to communicate openly with their doctors.

"This does not preclude a patient from asking for the test and the physician offering the test," says LeFevre. "There should be an open and honest discussion with significant known harms."

And while the USPSTF's recommendations may drastically reduce the number of men who undergo a PSA blood test, those considered to have a strong family history of prostate cancer -- in other words, more than one first degree relative with prostate cancer before the age of 69 -- may still want to consider getting it.

Copyright 2012 ABC News Radio


Beehive Glue Stops Prostate Cancer in Mice

Comstock/Thinkstock(CHICAGO) -- Researchers at the University of Chicago found that a compound made in honeybee hives seems to stop the spread of prostate cancer cells in mice.

The compound, called caffeic acid phenethyl ester or CAPE, is made from propolis, the resin honeybees use to patch holes in their hives. The product has been known and used for centuries as a natural remedy for teeth and skin, as well as a defense against viruses and bacteria.

When the researchers fed CAPE to mice that had early stages of the human form of prostate cancer, it seemed to stop the cancer in its tracks.

“Their tumors simply stopped growing,” said Richard Jones, the study’s author and a cancer researcher at the University of Chicago. “When we stopped feeding the mice CAPE, their tumors returned.”

After six weeks, the tumors in mice eating CAPE were 50 percent smaller than the tumors in mice not getting the compound, whose tumors kept growing unchecked. The CAPE mice also didn’t lose any weight during the treatment, which researchers said indicated that the compound was not overly toxic.

The researchers said the compound didn’t kill the cancer, but it appeared to stop the growth of the cancer cells by masking their ability to use a system of signals to detect nutrition. If cells don’t sense the presence of the food they need, such as glucose, they will stop growing.

The study was only in mice, and the compound has not yet been tested in human cancer patients. But Jones said the cell pathways targeted by CAPE are found in all mammal cells. He said he is hopeful that CAPE will prove useful against cancer in humans, most likely in combination with other available cancer therapies.

“One can imagine in the context of cancer prevention or early stage cancer, administering this molecule as a natural low-risk way to reduce proliferation of this and other types of cancer cells,” Jones said.

A next step will be for clinicians to test the compound in human patients.

Copyright 2012 ABC News Radio


US Men Ignoring 2008 Prostate Screening Guidelines 

Hemera/Thinkstock(CHICAGO) -- Warren Buffett’s decision to undergo prostate cancer screening reflects the reality that nearly half of American men 75 and older continue being tested despite official recommendations against doing so, researchers reported Tuesday.

“PSA screening for more than 40 percent of men 75 or older is inappropriate,” said Dr. Scott G. Eggener, an assistant professor of surgery at University of Chicago Medical Center, whose research confirms that older men aren’t heeding 2008 guidance from the U.S. Preventive Services Task Force.

“Selective screening is reasonable to consider for the healthiest men over age 75, but for the large majority of men in this age group, early detection can lead to treatment of a disease that will probably never cause a problem,” he said.

In 2008, the USPSTF issued a recommendation that found limited benefit for screening men ages 75 and older for prostate cancer. Last year, the task force drafted guidelines that said prostate screening was of limited benefit for helping men of any age live longer, and that harms of unnecessary treatments often outweigh benefits.

Eggener and his colleagues set out to determine whether men were paying attention to the guidelines. They found that in 2005, two years before issuance of the guidelines, 43 percent of men 75 and older underwent prostate-specific antigen (PSA) testing, which measures levels of a protein in the blood.

In 2010, when the guidelines had been out for two years, the screening rate among those men rose slightly to 43.9 percent, according to results appearing in this week’s issue of JAMA.

Last week, Buffett, the 81-year-old CEO of Berkshire Hathaway, announced that he would undergo radiation treatment beginning in mid-July for Stage 1 prostate cancer, and that a CT scan, bone scan and MRI found no evidence it had spread.

At the time, top U.S. urologists and prostate surgeons reacted to the announcement by saying that most men with newly diagnosed prostate cancer are likely to die from something else.

However, there are exceptions, as world-renowned prostate cancer expert Dr. Patrick Walsh, a urology professor at Johns Hopkins Medical Institutions in Baltimore, pointed out to ABC News, citing a University of Rochester study appearing last year in the journal Cancer that found half of the deaths from prostate cancer “occur in men who are diagnosed after the age of 75.”

“The fact is that older men who are diagnosed with prostate cancer oftentimes have more advanced disease than younger men -- the opposite of what we used to believe,” Walsh said.

Some older men can have aggressive Stage 1 tumors, which despite being confined to the prostate gland, contain highly abnormal cells capable of spreading quickly, Walsh said.

Dr. William J. Catalona, director of the Clinical Prostate Cancer Program at Northwestern University in Chicago, told ABC News that Buffett’s case “shows how valuable the PSA test is, especially in view of a rumor I heard that the USPSTF will probably release its final recommendation against PSA screening in the next few weeks.”

Catalona described PSA testing as “the most effective way to detect prostate cancer in its curable stages and if used intelligently it reduces the chances of dying from prostate cancer by nearly 50 percent. Warren Buffett is no dummie.”

Eggener and his colleagues reviewed cancer data from the National Health Interview Survey, which follows a representative group of 87,500 Americans. They focused on men aged 40 and older who said they underwent prostate cancer screening as part of a routine exam. Screening rates were unchanged between 2005 and 2010 in all age groups, Eggener and his colleagues reported. They found PSA screening more common among men 75 and older than those 40 to 49 and 50 to 59.

The study authors said their data likely underestimated the rate of men not undergoing PSA testing enough, because self-reports are lower than rates found when researchers review actual medical records.

They recommended monitoring of the effect of the 2011 USPSTF recommendations.

Copyright 2012 ABC News Radio


Is Warren Buffett's Cancer Treatment Necessary?

Scott Eells/Bloomberg via Getty Images(NEW YORK) -- Warren Buffett's decision to undergo radiation therapy for stage 1 prostate cancer has refocused attention on a debate over screening and treating older men for a disease that most often won't kill them.

Prostate cancer specialists worry that because the high-profile, 81-year-old billionaire has chosen two months of daily radiation treatments, other men automatically will "assume that must be the right treatment and it must be good for me," said Dr. Peter Scardino, chairman of the surgery department at Memorial Sloan-Kettering Cancer Center in New York.

"Generally, in a person over 80 years old, you'd be very hesitant to treat a prostate cancer unless it's clearly life-threatening," Scardino said.  "Doctors caution men [that] at that age prostate cancer is very common.  Most of the time it's not dangerous to their life or health.  It's unusual, in our experience, to treat someone over 80, although I've done it."

Of course, no doctor wants to second-guess Buffett's decision, especially without at least two key pieces of information that he didn't disclose when he announced his diagnosis on Tuesday: his PSA score and his Gleason score, both of which help determine whether cancer is low-risk or high-risk, Scardino and other top prostate specialists said.

The PSA test measures levels of prostate specific antigen (PSA), a protein that increases in prostate cancer as well as in benign prostate enlargement.

The Gleason score measures how closely cancer cells resemble normal tissue: The higher the score, the more abnormal the tissue and the more likely it is to spread.

"One would have to know the PSA level and the Gleason grade of the cancer on biopsy to make a proper decision, but the burden would be on the physician to show why immediate treatment is needed for a stage 1 cancer in an 81-year-old man," Scardino said.

Although stage 1 prostate cancer, by definition, hasn't spread beyond the prostate gland, "you could still be stage 1 and have an aggressive tumor," said Dr. Patrick Walsh, a urology professor at Johns Hopkins Medical Institutions in Baltimore who is among the world's top authorities on prostate cancer.

Walsh said one of his own patients, a man whose case had similarities to Buffett's, had his PSA score rise from 2.5 to 8.0 within a year and had a Gleason score of 8 on a scale of 0 to 10, indicating highly abnormal cells.

While readily acknowledging he didn't have important details of Buffett's case, he suggested that "the fact that he is waiting three months to begin radiation suggests to me that he might be going to receive neoadjuvant hormonal therapy and that is consistent with more aggressive disease."

Copyright 2012 ABC News Radio

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