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Prostate-specific antigen. Prostate-specific antigen (PSA) is secreted by the epithelial cells of the prostate gland and can be detected in a sample of blood. [14] PSA is present in small quantities in the serum of men with healthy prostates, but is often elevated in the presence of prostate cancer or other prostate disorders. [15]
After surgery or radiation therapy, PSA may start to rise again, which is called biochemical recurrence if a certain threshold is met in PSA levels (typically 0.1 or 0.2 ng/ml for surgery). At 10 years of follow-up after surgery, there is an overall risk of biochemical recurrence of 30–50%, depending on the initial risk state, and salvage ...
Several urological societies' guidelines recommend magnetic resonance imaging (MRI) to evaluate the prostate for potential tumors in men with high PSA levels. MRI results can help distinguish those who have potentially dangerous tumors from those who do not. [26] A definitive diagnosis of prostate cancer requires a biopsy of the prostate.
[54] [55] For those with elevated levels of PSA, TRUS guided biopsy is performed to take a sample of the prostate for investigation. [56] Although MRI is more accurate than TRUS in determining prostate volume, TRUS is less expensive and almost as accurate as MRI. Therefore, TRUS is still preferred to measure prostate volume. [57]
PSA screening is controversial as PSA may become elevated due to non-cancerous conditions such as benign prostatic hyperplasia (BPH), by infection, or by manipulation of the prostate during surgery or catheterization. Additionally many prostate cancers detected by screening develop so slowly that they would not cause problems during a man's ...
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Although the role of surgery in these patients remains uncertain, those with high-risk disease are usually treated with radiotherapy and a long duration of hormonal ablation. Many high-risk patients are not cured by this treatment, and the search for better treatments in this group is a particularly pressing concern in prostate cancer research.
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