“…Earlier reports showed that the PSA level may not reflect the pathological stage progression in some PCa patients, whose PSA levels were below 0.5 ng/ml with nodal metastasis after ADT (29,30). Meanwhile, a recent clinical trial of abiraterone, a powerful drug that suppressed androgen biosynthesis, also found that although 79% of PCa patients have a decline in PSA level of 50% or more, 52% of PCa patients have either increased new bone lesions or increased intensity of existing bone lesions, which these investigators called "bone scan flare," after 4 months of treatment (31).…”