The utility of digital rectal examination after radical radiotherapy for prostate cancer.
OBJECTIVE
The aim of the current study was to determine the utility of routine digital rectal examination (DRE) after radical radiotherapy for prostate cancer.


METHODS
Between 1990 and 1999, 899 patients with clinically localised prostatic adenocarcinoma (T1-4, N0/Nx, M0/Mx) underwent neoadjuvant androgen deprivation and radical radiotherapy at the Royal Marsden Hospital. Patients were followed with serum prostate-specific antigen (PSA) test and DRE carried out at 6-monthly intervals for the first 2 years, and then annually.


RESULTS
At a median follow-up of 5 years, 39 out of 899 cases (4.3%) had local recurrence detected on DRE. DRE failed to detect any local recurrences in the absence of a rising PSA. The lowest serum PSA concentration at the time of clinically detectable local recurrence was 1.7 ng/ml.


CONCLUSIONS
These findings question the standard model of follow-up after radiotherapy for prostate cancer, and suggest that alternatives, such as telephone clinics, should be considered.
Doneux
A
A
The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, Surrey, UK.
Parker
C C
CC
Norman
A
A
Eeles
R
R
Howich
A
A
Huddart
R
R
Dearnaley
D
D
D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010808:Physical Examination / Q000379:methods; D011182:Postoperative Care; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D011878:Radiotherapy / Q000379:methods; D012007:Rectum / Q000503:physiopathology
D017430:Prostate-Specific Antigen