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Prostate bed massage as a means to determine the source of a rising prostate specific antigen after radical
1Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina 27710, USA.
Purpose:
To determine the value of prostate bed massage as a means to determine whether a rising prostate specific antigen (PSA) after radical prostatectomy is due to local recurrence or distant metastases.
Methods And Materials:
Eighteen patients referred for pelvic radiotherapy because of a rising PSA after radical prostatectomy had PSA levels measured immediately before and 5 minutes after a vigorous 30-second massage of the prostate bed.
Results:
Only one of the 18 (5%) patients experienced a rise in their PSA following vigorous prostate bed massage. Fifteen of the 18 (83%) patients' PSA levels declined after radiotherapy, suggesting that recurrent prostate cancer had been present in the prostate bed at the time of prostate massage in these patients. Only 1 of these 15 patients (7%) had a rise in their PSA after massage.
Conclusion:
Prostate bed massage, as performed in this study, was not helpful to determine whether a rise in PSA after radical prostatectomy was due to local or distant recurrence.
