Patient evaluation if prostate-specific antigen becomes elevated following radical prostatectomy or radiation therapy

Prostate-specific antigen (PSA) is the most sensitive and clinically useful method for monitoring patients following definitive therapy for prostate cancer. A "detectable" value following radical prostatectomy and an increasing level following radiation therapy are both indicative of recurrent/residual disease. The persistent cancer may be local or distant; the rate of increase of serum PSA can be useful in distinguishing between local and metastatic disease. A computed tomography or magnetic residence imaging scan may be useful for evaluating abdominal and pelvic lymph nodes, and the radionuclide bone scan is an effective tool for assessing the skeleton when the serum PSA concentration becomes elevated following treatment.