Rising or persistently elevated serum PSA following radical prostatectomy for prostate cancer: Management
- W Robert Lee, MD, MS, MEd
W Robert Lee, MD, MS, MEd
- Section Editor — Prostate Cancer
- Professor of Radiation Oncology
- Duke University Medical Center
- Section Editors
- Nicholas Vogelzang, MD
Nicholas Vogelzang, MD
- Section Editor — Prostate Cancer
- Professor of Medicine
- University of Nevada School of Medicine
- US Oncology Research
- Jerome P Richie, MD, FACS
Jerome P Richie, MD, FACS
- Section Editor — Cancer of the Urethra, Penis, and Ureter; Urologic Surgery; Prostate Cancer
- Elliott Carr Cutler Professor of Surgery
- Harvard Medical School
Prostate-specific antigen (PSA) is a sensitive and specific serum marker for prostate tissue. Serial measurements are routinely obtained to detect early disease recurrence in men who have received definitive treatment for localized disease. (See "Follow-up surveillance during and after treatment for prostate cancer".)
The use of salvage radiation therapy (RT) for men who have a persistently elevated or rising PSA following radical prostatectomy for early stage disease will be reviewed here. Other topics relevant to patients with a rising PSA include:To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- GENERAL APPROACH
- DEFINITION OF BIOCHEMICAL FAILURE AFTER RADICAL PROSTATECTOMY
- Low, persistently elevated PSA
- NATURAL HISTORY OF BIOCHEMICAL FAILURE
- SALVAGE RT
- Prognostic factors and impact on survival
- Timing of salvage RT
- Dose of radiation
- Treatment volume
- Salvage RT versus adjuvant RT
- Salvage RT plus ADT
- SUBSEQUENT BIOCHEMICAL RECURRENCE
- ROLE OF SURGERY FOR ISOLATED PELVIC RECURRENCE
- OLIGOMETASTATIC DISEASE
- ADT ALONE
- SUMMARY AND RECOMMENDATIONS