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:
Subscribers log in hereLiterature review current through: Jul 2017. | This topic last updated: Jul 11, 2017.References
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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