Rising PSA after a radical treatment.

Abstract

Despite improvements in detection of early prostate cancer and surgical technique, approximately 25% of men develop biochemical recurrence following radical prostatectomy. Recurrence after local prostate cancer treatment, detectable only by a rise in serum prostate-specific antigen (PSA), is an increasingly common problem facing clinicians. Analysis of clinical and pathological factors can indicate the likelihood of treatment failure. In addition, at biochemical failure, PSA velocity or doubling time may indicate whether recurrent disease is local or distant to the prostate bed. Those thought to have local recurrence may benefit from radiation therapy, whereas those thought to have metastatic disease may benefit from systemic treatment, the most common being androgen deprivation. Some patients may be candidates for surveillance alone.