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Rising prostate specific antigen after radical prostatectomy: a case based review.
1Division of Urology, The Prostate Centre at Vancouver General Hospital, University of British Columbia,Vancouver, B.C, Canada.
The Canadian Journal of Urology
|September 21, 2001
Summary
Rising prostate-specific antigen (PSA) after prostate cancer surgery affects many men. This review covers PSA recurrence, its natural history, and management options for this challenging clinical scenario.
Area of Science:
- Urology
- Oncology
Background:
- Prostate-specific antigen (PSA) is crucial for diagnosing and staging prostate cancer.
- It also serves as a marker for detecting residual or recurrent cancer post-treatment.
Observation:
- In 1998, 200,000 prostate cancer cases were reported, with 134,000 receiving definitive therapy.
- Approximately 75,000 men underwent radical prostatectomy.
- 20%-50% of these patients experience PSA-only recurrence, estimating 15,000-38,000 annual cases.
Findings:
- Elevated PSA often precedes clinical failure by years.
- PSA recurrence presents a significant management challenge due to a lack of definitive guidelines.
Implications:
- This review defines PSA recurrence, discusses its natural history, and outlines diagnostic and therapeutic strategies.
- Case studies illustrate the management of PSA recurrence after radical prostatectomy.