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Updated: Jul 6, 2026
05:19
A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance
Published on: November 7, 2025
The postchemotherapy PSA surge syndrome.
R Thuret1, C Massard1, M Gross-Goupil1
1Department of Medicine.
Summary
Temporary increases in prostate-specific antigen (PSA) levels, known as PSA surges, can occur in patients with castration-refractory prostate cancer (CRPC) undergoing chemotherapy. These surges may precede a positive treatment response, so early discontinuation should be avoided.
Area of Science:
- Oncology
- Urology
Background:
- Chemotherapy is a standard treatment for castration-refractory prostate cancer (CRPC).
- Consensus criteria define CRPC response by a ≥50% decline in serum prostate-specific antigen (PSA) confirmed 4 weeks later.
Purpose of the Study:
- To investigate early serum PSA changes in CRPC patients receiving chemotherapy.
- To correlate these early PSA changes with subsequent treatment response assessment.
Main Methods:
- Serum PSA levels were monitored every 3 weeks in 79 CRPC patients undergoing chemotherapy.
- Time course of serum PSA levels was analyzed for correlation with response.
Main Results:
- A PSA response or stabilization was observed in 40% and 38% of patients, respectively, after first-line chemotherapy.
- Among responding or stabilizing patients, 20% experienced an initial PSA rise within the first 8 weeks, followed by a decline.
- This PSA surge phenomenon was also noted in second-line chemotherapy patients (30% of responders).
Conclusions:
- Postchemotherapy PSA surges are not uncommon in CRPC patients who respond to treatment.
- Physicians should recognize this effect to prevent premature cessation of chemotherapy.
- Awareness of PSA surges is crucial for accurate early response assessment in CRPC.
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