title: Prostate-specific antigen as a marker of disease activity in prostate cancer.
abstract: Despite the impact of prostate-specific antigen (PSA) testing on the detection and management of prostate cancer, controversy about its usefulness as a marker of disease activity continues. This review, based on a recent roundtable discussion, examines whether PSA measurements can be used rationally in several clinical settings. Following radical prostatectomy and radiation therapy, prediction of survival by PSA level is most reliable in high-risk patients. PSA doubling time after radiation therapy is the strongest predictor of biochemical failure. PSA measurements have been associated with inconsistent results following hormonal treatment; reduced PSA levels may result from antiandrogen treatment, which decreases expression of the PSA gene, and therefore, the level of PSA production. In the setting of primary and secondary cancer prevention, PSA is important in risk stratification when selecting patients for studies. Part 2 of this two-part article, which began in the August issue, discusses the role of PSA in hormonal and drug therapies and in primary and secondary chemoprevention.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Alan W
authors.initials: AW
authors.lastname: Partin
authors.forename: Gerald E
authors.initials: GE
authors.lastname: Hanks
authors.forename: Eric A
authors.initials: EA
authors.lastname: Klein
authors.forename: Judd W
authors.initials: JW
authors.lastname: Moul
authors.forename: William G
authors.initials: WG
authors.lastname: Nelson
authors.forename: Howard I
authors.initials: HI
authors.lastname: Scher
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D009376:Neoplasms, Hormone-Dependent / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D011878:Radiotherapy; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen