Use of prostate-specific antigen in the follow-up of patients with localized prostate cancer: results of a nationwide survey of urologists.
OBJECTIVE
To perform a nationwide survey of urologists' opinions and behavior regarding the use of prostate-specific antigen (PSA) in prostate cancer follow-up and secondary treatment.


METHODS
A random sample of 300 urologists was interviewed. Content areas included defining recurrence in prostate cancer, factors that influence initiation of secondary treatment in this setting, and need for additional clinical trial information in recurrent prostate cancer.


RESULTS
Seventy-eight percent of urologists indicated that absolute PSA levels were of high or very high importance when making follow-up decisions. When defining a rising PSA level, 83% of urologists surveyed use the American Society for Therapeutic Radiology and Oncology definition of failure. An additional 78% use PSA doubling time. When asked about the importance of rapidly reducing PSA levels after recurrence, 61% said it was of high or very high importance to them, but 81% said it was of high or very high importance to their patients.


CONCLUSIONS
Results from the current study indicate that urologists consider PSA failure to be an important outcome in patients with prostate cancer. Researchers and policy makers need to consider this outcome when designing studies of prostate cancer.
Penson
David
D
Norris Comprehensive Cancer Center, Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California 90089, USA. penson@usc.edu
Moul
Judd
J
Gandhi
Sanjay
S
Newling
Don
D
D003625:Data Collection; D018450:Disease Progression; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D014572:Urology
D017430:Prostate-Specific Antigen