Prostate-specific antigen and biomarkers for prostate cancer

Mapping Intimacies ◽

10.1093/med/9780199659579.003.0061 ◽

2017 ◽

Author(s):

Hans Lilja

Keyword(s):

Prostate Cancer ◽

Prostate Specific Antigen ◽

Specific Antigen ◽

Opportunistic Screening ◽

High Risk Prostate Cancer ◽

Psa Testing ◽

Risk Prostate Cancer ◽

Low Risk Prostate Cancer ◽

Prostatic Diseases ◽

Significant Disease

Prostate-specific antigen (PSA) is a kallikrein serine protease secreted by the prostate to liquefy the ejaculatory coagulum. Changes in the blood/prostate barrier allows PSA to enter the circulation in men with prostate cancer and other inflammatory prostatic diseases. The commonest method for detection of men at risk of prostate cancer is PSA testing, which is typically used in an opportunistic screening setting. The widespread use of PSA testing leads to overdiagnosis and overtreatment of many men with low-risk prostate cancer, but can allow the identification of those with significant disease requiring radical treatment. This lack of specificity for high-risk prostate cancer has led to the need for more accurate biomarkers or methods to improve the use of PSA testing.

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The Role of Targeted Focal Therapy in the Management of Low-Risk Prostate Cancer: Update on Current Challenges

Prostate Cancer ◽

10.1155/2012/587139 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

Daniel W. Smith ◽

Diliana Stoimenova ◽

Khadijah Eid ◽

Al Barqawi

Keyword(s):

Prostate Cancer ◽

Side Effects ◽

Specific Antigen ◽

Three Dimensional ◽

Focal Therapy ◽

The United States ◽

Psa Testing ◽

Three Dimensional Mapping ◽

Risk Prostate Cancer ◽

Low Risk Prostate Cancer

Prostate cancer is one of the most prevalent cancers among men in the United States, second only to nonmelanomatous skin cancer. Since prostate-specific antigen (PSA) testing came into widespread use in the late 1980s, there has been a sharp increase in annual prostate cancer incidence. Cancer-specific mortality, though, is relatively low. The majority of these cancers will not progress to mortal disease, yet most men who are diagnosed opt for treatment as opposed to observation or active surveillance (AS). These men are thus burdened with the morbidities associated with aggressive treatments, commonly incontinence and erectile dysfunction, without receiving a mortality benefit. It is therefore necessary to both continue investigating outcomes associated with AS and to develop less invasive techniques for those who desire treatment but without the significant potential for quality-of-life side effects seen with aggressive modalities. The goals of this paper are to discuss the problems of overdiagnosis and overtreatment since the advent of PSA screening as well as the potential for targeted focal therapy (TFT) to bridge the gap between AS and definitive therapies. Furthermore, patient selection criteria for TFT, costs, side effects, and brachytherapy template-guided three-dimensional mapping biopsies (3DMB) for tumor localization will also be explored.

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