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Updated: Oct 7, 2026

A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance
Published on: November 7, 2025
From negative bone scintigraphy to oncologic superscan within five months: Explosive PSA kinetics in grade group 5
Bartłomiej Olczak1, Katarzyna Sklinda2, Radoslaw Szostek1
1Clinical Department of Urology and Oncological Urology, National Medical Institute of the Ministry of the Interior and Administration, Wołoska 137, Warsaw, 02-507, Poland.
Abstract:
A 78-year-old man presented with a prostate-specific antigen (PSA) level of 35 ng/mL, a PI-RADS 5 lesion on multiparametric prostate MRI, and negative whole-body bone scintigraphy. Within five months, PSA increased to 1244 ng/mL despite minimal radiological progression of the primary tumour. Repeat MRI demonstrated multiple osseous lesions, repeat MRI-ultrasound fusion-guided biopsy confirmed Grade Group 5 adenocarcinoma with cribriform architecture and perineural invasion, and repeat bone scintigraphy revealed an oncologic superscan consistent with high-volume metastatic disease. This case demonstrates that rapidly rising PSA levels accompanied by new skeletal symptoms should prompt immediate repeat staging despite initially negative whole-body bone scintigraphy.
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