What does prostate-specific antigen recurrence mean?

Abstract

The return of the prostate-specific antigen (PSA) to a detectable serum level (PSA recurrence) is usually the first sign of recurrent disease after radical prostatectomy. PSA recurrence generally occurs in men who are otherwise asymptomatic and may occur as late as 5 to 10 years after surgery. Men in this situation want to know what this means regarding the likelihood of clinical disease recurrence and, ultimately, survival. An evaluation for recurrent disease is warranted but generally does not reveal objective signs of clinical disease in the majority of men. Although select men may benefit from salvage local therapy, a PSA recurrence is most often an early sign of distant disease present since the time of surgery. The decision whether or not to initiate systemic therapy in these men is difficult and controversial. Fortunately, recent developments in determining the significance of a PSA recurrence may help the patient and his physician to make a more informed decision regarding treatment options.

PET/CT zur Diagnostik des Prostatakarzinomes

“…Erste Ergebnisse der endorektalen MRT in Kombination mit der Ganzkörperspule liegen nur bei geringen Fallzahlen vor und sind derzeit aufgrund von technischen Unpässlichkeiten noch nicht aussagekräftig [60]. Die Frage nach aktivem Tumorgewebe und Resttumor kann somit durch die MRT alleine nicht beantwortet werden [61,62]; eine endorektale MRT in Kombination mit einer MR-Spektroskopie hat Sensivitäten und Spezifitäten um die 90 %, kann aber die Frage einer pelvinen/paraaortalen Lymphknotenmetastasierung oder einer ossä-ren Fernmetatsasierung in einem Untersuchungsvorgang nicht zufrieden stellend beantworten [63].…”

The Practice of Scottish Urologists in the Assessment and Management of Fracture Risk in the Ageing Male being Treated for Prostate Cancer

“…Low testosterone levels as well as hypovitaminosis D also occur in this population, which explains why osteopenia or osteoporosis is present in 10-25% of men with prostate cancer even before ADT [9,10]. This, coupled with the likelihood of bony metastases leading to pathological fractures, makes increased fracture risk a dangerous side effect that can cause critical damage [11,12,13,14]. Although many studies have been carried out to determine the best form of treatment for this particular side effect, not much has been done to focus on what urologists comprehend and practice when faced with prostate cancer patients.…”