PSA bounce is common following seed implantation for prostate cancer. It produces anxiety in men previously treated for prostate cancer and confounds the diagnosis of recurrence.
Young men with prostate cancer treated with brachytherapy have a significantly higher frequency, earlier onset and longer duration of PSA bounce than older men.
Intermediate treatment outcome analysis of modern simultaneous radiation supports the principles of radiation dose intensification for intracapsular disease plus the treatment of potential microscopic capsular penetration.
PSA nadir is the fundamental measurement that determines possible cure after radiotherapy. Except for perhaps rare occasions, men must at least achieve a nadir of 0.5 ng/ml. or less to be cured of prostate cancer by irradiation. However, the prognostic value of this nadir level depends on most men achieving a nadir of 0.2 ng/ml or less. Disease freedom for radiotherapy, defined as achievement and maintenance of PSA nadir 0.5 ng/ml or less, is reasonable.
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