Management of Biochemical Failure of Prostate Cancer after Radical prostatectomy: Recent Advances and Future Opportunities
Journal Title: Journal of Oncology and Cancer Research - Year 2017, Vol 1, Issue 1
Abstract
Prostate cancer is the most common new cancer diagnosis and the third leading cause of cancer death in men in the United States. With the use of prostate-specific antigen (PSA) as a screening test, most new prostate cancers are diagnosed when the disease is localized. Standard definitive treatment options for localized prostate cancer include radical prostatectomy (RP) or radiation therapy (RT). The addition of androgen deprivation therapy to RT has been shown to improve treatment outcomes for intermediate and high risk prostate cancers. For patients who undergo RP, the PSA level should be undetectable after the surgery. However, more than a third of patients would develop recurrence of disease, which initially presents with an increase in the PSA to detectable level. The majority of these patients would have no suspicious findings in diagnostic work-up including clinical examination and imaging studies, and the condition is categorized as biochemical failure (BF). Without salvage treatment, the disease would progress to the development of local recurrence or distant metastasis that can be eventually detected clinically. However, the pace of disease progression is variable and may take many years before sites of recurrence can be identified. Management options for patients with BF include salvage radiation therapy, androgen deprivation therapy, and watchful waiting. Salvage radiation therapy is the only treatment that can potentially achieve a cure of the disease. Despite salvage RT, further relapse occurs in > 50% of these patients. Risk factors associated with further relapse include a short time interval from RP to biochemical relapse, PSA level at the time of salvage RT > 1 ng/ml, short PSA doubling time, and presence of seminal vesicle involvement.
Authors and Affiliations
William W. Wong
Keywords
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- EP ID EP249327
- DOI 10.28967/jocr.2017.01.17007
- Views 107
- Downloads 0
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