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| References
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Prostate-screening,
benign enlargement and cancer |
| 2.
Bangma CH, Blijenberg BG, Schroder FH. Prostate-specific
antigen: Its clinical use and application in screening for
prostate cancer. Scandinavian Journal of Clinical &
Laboratory Investigation - Supplement Vol 55.(221.) (pp.35.-44.),
1995.
Abstract: Prostate cancer in most European countries is
the second most frequent cancer in males and the second
most frequent cause of cancer death. Prostate specific antigen
(PSA) is an important tumour marker, which relates to many
aspects of this disease. It has been shown that PSA is helpful
in the early diagnosis of prostate cancer and in this respect
is superior to other available tests like rectal examination
and transrectal ultrasonography. PSA is also helpful in
staging of locally confined disease. It can be used to identify
or exclude local extension of disease, if combined with
T category and grade of differentiation determined on biopsy.
The same parameters also give an indication of the presence
of lymph node metastases, which may prevent unnecessary
and invasive staging procedures in certain groups of patients
with favourable prognostic factors and a low PSA value.
PSA is less suitable as a marker for metastatic disease.
Progression of untreated prostate cancer in various stages
can be monitored by PSA. The true value of the marker in
this respect is still underexplored. It may be possible
that PSA will be shown to differentiate effectively between
aggressive and non-progressive disease. In this respect,
it could become an essential tool to identify those patients
that may not require treatment at all. PSA is also a useful
marker for therapy response. An elevation of PSA after radical
prostatectomy indicates local or metastatic progression,
which will occur within 1-2 years. PSA is an androgen dependent
enzyme and decreases under endocrine treatment. It is unexplained
why in spite of its endocrine dependent character, PSA rises
with endocrine independent progression of prostate cancer.
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