Management of the patient with a rising PSA alone.

Journal Article (Review)

PSA-only recurrence after definitive RP or RT for PCA is an increasingly com-mon scenario. The very definition of advanced prostate cancer is changing. Multimodal therapy improves cancer-specific outcomes especially in men with high-risk disease. After RP, a detectable serum PSA has been considered suggestive of PCA recurrence. After RT, the ASTRO definition of BCR has been widely used to define BCR. Both of these definitions of BCR are subject to dispute. The kinetics of a rising PSA (PSA doubling time) appears to be the best surrogate marker for disease risk, clinical progression, and ultimately cancer-specific death. Therapeutic options include salvage RT after primary RP or systemic HT through surgical/chemical castration, antiandrogens, or nontraditional HT. Re-cent studies suggest that early HT can provide modest survival benefits, but at both an economic cost and decreased quality of life. The diminished side effects of an oral antiandrogen are appealing, and may be as efficacious as castration therapies in low-volume disease. More clinical trials are needed to determine the best treatments, alone and in combination. The potential opportunities for novel therapeutic agents with low associated morbidity are great.

Full Text

Duke Authors

Cited Authors

  • Moul, JW; Ward, JF

Published Date

  • August 2006

Published In

Volume / Issue

  • 20 / 4

Start / End Page

  • 897 - 908

PubMed ID

  • 16861121

Pubmed Central ID

  • 16861121

International Standard Serial Number (ISSN)

  • 0889-8588

Digital Object Identifier (DOI)

  • 10.1016/j.hoc.2006.03.006


  • eng

Conference Location

  • United States