[Value of determining prostate specific antigen in follow-up of prostatic cancer]

The value of measuring serum prostate specific antigen (PSA) in monitoring cases of prostatic cancer was studied in 239 patients. 30 patients with benign prostatic hyperplasia served as controls. The patients were treated by radical prostatectomy, radiotherapy or chemotherapy. In the controls PSA levels were elevated in 60%, indicating that PSA measurement is not specific for prostatic cancer. Among 35 patients before and after radical prostatectomy, in those without disease progression, PSA levels were repeatedly low, but were elevated in all with progression. Among 25 patients after radiation and in 28 before and after radiation, low PSA levels were found in all those, without disease progression. High PSA levels, or a rise in levels after irradiation, preceded local growth or metastatic spread. In the 95 patients with metastatic spread who received hormone-and/or chemo-therapy, low PSA levels following initiation of treatment, were a favorable prognostic indicator, with a sensitivity of 100%. High levels, or a rise of levels after initiation of treatment indicated disease progression. The rise in PSA levels preceded clinical evidence of progression by 0 to 30 months. We conclude that serum PSA is a valuable marker for following patients with prostatic cancer.