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Definition |
Primary curative procedures such as RP, and RT are well-established therapeutic options in the management of localised PCa. Despite technical improvements, there is still a significant risk of cancer recurrence after therapy. Between 27% and 53% of all patients undergoing RP or RT develop PSA-recurrence. While a rising PSA level universally antedates metastatic progression and prostate-cancer-specific mortality (PCSM), physicians must inform the patient that the natural history of PSA-only recurrence may be prolonged and that a PSA rise is not a surrogate for these survival endpoints. Physicians treating patients with PSA-only recurrence face a difficult set of decisions in attempting to delay the onset of metastatic disease and death while avoiding over-treating patients whose disease may never affect their OS or QoL. It has to be emphasised that the treatment recommendations for these patients should be given after discussion with a multidisciplinary team.
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