Prostate specific antigen

  • Long-term prognostic significance of rising PSA levels following radiotherapy for localized prostate cancer - focus on overall survival.

    The aim of this study was to evaluate the long-term prognostic significance of rising PSA levels, particularly focussing on overall survival.

    Two hundred ninety-five patients with localized prostate cancer were either treated with low-dose-rate (LDR) brachytherapy with I-125 seeds as monotherapy (n = 94; 145Gy), high-dose-rate (HDR) brachytherapy with Ir-192 as a boost to external beam RT (n = 66; 50.

    Published June 23, 2017
  • Long-term Results of External Beam Radiotherapy for Prostate Cancer with Prostate-specific Antigen of More Than 50 ng/ml and Without Evidence of Lymph Node or Distant Metastasis.

    To evaluate long-term treatment outcomes of external beam radiotherapy for prostate cancer with a pretreatment prostate-specific antigen (PSA) level of more than 50 ng/ml and without evidence of lymph node or distant metastasis.

    Published April 3, 2018
  • Low-dose-rate brachytherapy as a minimally invasive curative treatment for localised prostate cancer has excellent oncological and functional outcomes: a retrospective analysis from a single centre.

    Low-dose-rate (LDR) brachytherapy is a widely used therapeutic option for localised prostate cancer. The aim of this study was to analyse the oncological and functional outcomes after 10 years of experience with brachytherapy for localised prostate cancer.

    Published November 7, 2018
  • Metformin Has a Positive Therapeutic Effect on Prostate Cancer in Patients With Type 2 Diabetes Mellitus.

    Prostate cancer and type 2 diabetes mellitus (DM2) are both common diseases found in the elderly male population. The diabetic drug, metformin, has been shown to have antineoplastic properties and demonstrated better treatment outcomes when used as adjuvant therapy in patients with breast cancer.

    Published April 20, 2016
  • Methodology to study the three-dimensional spatial distribution of prostate cancer and their dependence on clinical parameters.

    A methodology to study the relationship between clinical variables [e.g., prostate specific antigen (PSA) or Gleason score] and cancer spatial distribution is described.

    Published August 10, 2015
  • Multiparametric Magnetic Resonance Imaging for Active Surveillance of Prostate Cancer.

    Active surveillance has gained popularity as an acceptable management option for men with low-risk prostate cancer. Successful utilization of this strategy can delay or prevent unnecessary interventions - thereby reducing morbidity associated with overtreatment.

    Published October 19, 2017
  • Past, Current, and Future Incidence Rates and Burden of Metastatic Prostate Cancer in the United States.

    Metastatic prostate cancer (PCA) remains a highly lethal malignancy in the USA. As prostate-specific antigen testing declines nationally, detailed assessment of current age- and race-specific incidence trends and quantitative forecasts are needed.

    Published May 31, 2019
  • Persistent Prostate-Specific Antigen After Radical Prostatectomy and Its Impact on Oncologic Outcomes.

    Persistent prostate-specific antigen (PSA) represents a poor prognostic factor for recurrence after radical prostatectomy (RP).

    To investigate the impact of persistent PSA at 6wk after RP on long-term oncologic outcomes and to assess patient characteristics associated with persistent PSA.

    Published March 8, 2019
  • Positive Association between Preoperative Total Testosterone Levels and Risk of Positive Surgical Margins by Prostate Cancer: Results in 476 Consecutive Patients Treated Only by Radical Prostatectomy.

    To evaluate preoperative total testosterone (TT) as a predictor of positive surgical margins (PSM) in prostate cancer (PCA).

    During the period from November 2014 to July 2017, preoperative TT was measured in 476 PCA patients undergoing only radical prostatectomy (RP) and including all risk classes.

    Published July 13, 2018
  • Potential of telmisartan in the treatment of benign prostatic hyperplasia.

    Benign prostatic hyperplasia (BPH) is a common health problem in aging men. This study was carried out to investigate the protective effect of telmisartan on testosterone induced-BPH in rats. Fifty-four male Wistar rats (200 - 250g) were randomly divided into 9 groups (n =6) and orally treated for 28 consecutive days: group 1- vehicle normal, olive oil (10 ml/kg); group 2- BPH model control (10 ml/kg); groups 3-5 - telmisartan (5, 10 or 20 mg/kg, respectively); group 6- pioglitazone (20 mg/kg); group 7- celecoxib (20 mg/kg); group 8- combination of telmisartan (5 mg/kg) and pioglitazone (20 mg/kg); group 9- combination of telmisartan (5 mg/kg) and celecoxib (20 mg/kg).

    Published July 22, 2017
  • Predictive factors for short-term biochemical recurrence-free survival after robot-assisted laparoscopic radical prostatectomy in high-risk prostate cancer patients.

    We aimed to assess the short-term oncological outcomes of robot-assisted laparoscopic radical prostatectomy to determine the predictive factors associated with biochemical recurrence in high-risk prostate cancer patients.

    Published April 16, 2019
  • Predictors of Time to Metastasis in Castration-Resistant Prostate Cancer.

    To investigate predictors of time to metastasis among men treated with androgen deprivation therapy (ADT) for non-metastatic prostate cancer who developed castration-resistant prostate cancer (CRPC) within the Shared Equal Access Regional Cancer Hospital (SEARCH) cohort.

    Published June 20, 2016
  • Preliminary study on ultrasound-guided prostate biopsy specimen scores.

    Prostate cancer (PCa) is the second most frequently diagnosed cancer in males worldwide and resulted in ~258,000 cases of cancer-associated mortality in 2008. The present study visually determined the pathology scores of PCa specimens by taking into account five characteristics, including the hardness, color, plumpness, transparency and uniformity of specimens.

    Published October 2, 2017
  • Prevelance of prostate cancer among Turkish men with prostate-specific antigen level of ≤100 ng/ml.

    Prostate cancer (PCa) is one of the most common cancers among men and has become a significant health problem in developing and developed countries. Prostate-specific antigen (PSA) is a useful marker for screening and monitoring the patients.

    Published December 4, 2018
  • Primary care perspective and implementation of a multidisciplinary, institutional prostate cancer screening algorithm embedded in the electronic health record.

    In response to controversy regarding prostate cancer (CaP) screening recommendations, a consolidated Duke Cancer Institute (DCI) multidisciplinary algorithm for CaP screening was developed and implemented.

    Published September 6, 2018
  • Prognostic Association of Prostate-specific Antigen Decline with Clinical Outcomes in Men with Metastatic Castration-resistant Prostate Cancer Treated with Enzalutamide in a Randomized Clinical Trial.

    In the PREVAIL study, enzalutamide provided significant improvements versus placebo in clinical outcomes in chemotherapy-naïve men with metastatic castration-resistant prostate cancer (mCRPC). The association of post-treatment prostate-specific antigen (PSA) decline with clinical outcomes may provide important prognostic information.

    Published July 8, 2019
  • Prophylactic Robotic-assisted Laparoscopic Radical Prostatectomy for Preoperative Suspicion of Prostate Cancer: Experience with 55 Cases: Beyond the Abstract

    Prophylactic surgery is considered acceptable for pre-malignant lesions and high level of risk of developing cancer of the colon and breast, especially in patients with family history [1-3].
    Published October 13, 2016
  • Prostate Cancer Diagnosis

    Signs and symptoms. Prostate cancer rarely demonstrates early symptoms. A nodule may be noticed on a digital rectal exam as tumor volume increases. Symptoms suggest locally advanced or metastatic disease.  With advanced disease, hematuria, obstructive symptoms and bone pain from metastases can be present.  It is less common to diagnosis advanced disease due to sceening with prostate specific antigen (PSA) and digital rectal exams (DRE).  A histological diagnosis is frequently made using prostate needle biospy with transurethral ultrasound guidance.  DRE and PSA are complementary tests and it is recommended that they are used in combination in assessing prostate cancer risk.   

    • Prostate Specific Antigen [PSA] Improves the postive predictive value of DRE for prostate cancer.
      • Biochemical characteristics.
        • PSA is a 240 amino acid single chain glycoprotein that has a molecular weight of 34 kd. It is coded on chromosome 19 (6 Kb: 4 introns, 5 exons), is homologous to members of the kallikrein gene superfamily, and is designated human kallikrein3 (hK3). It behaves as a serine protease.
      • Physiology.
        • PSA liquefies the seminal coagulum that is formed after ejaculation.
        • A substrate produced in the seminal vesicles has been identified. PSA has chymotrypsinand trypsin-like activity. Its half-life is 2.2 to 3.2 days.
      • Marker Properties
        • The generally used monoclonal assay (2 murine MAbs for two specific epitopes) suggest a normal serum value of 4.0 ng/mL. Serum values are not generally altered by DRE, but can be affected by urologic instrumentation, ejaculation, and prostate biopsy. 
        • Benign conditions that can raise PSA levels include prostatitis, prostate infarction, and benign prostatic hypertrophy.
        • The interpretation of PSA values should always include age, presence of urinary tract infection, recent diagnositc procedures, any prstate directed treatments.  
      • Cancer detection (see screening)
      • Treatment surveillance. Serum levels monitored after surgery and external beam radiation therapy. Surgical failure clearly defined by PSA level >0.4 ng/ml. Radiation failure currently defined by 3 successive rises in PSA over time. Several biases built into this definition.
    • Transrectal Ultrasound. Primarily used for appropriate needle placement during biopsy. Classic finding of hypoechoic lesion has a 30% chance of being prostate cancer
    • Prostate needle biopsy. Spring loaded gun obtains 10-13 cores of tissue from the gland under ultrasound guidance. Parameters such a percent positive cores can provide predictive information on treatment outcome. Procedure is well tolerated. Major side effect is hematospermia
    • Bone Scan. In patients with a PSA <10.0ng/ml the chance of a positive scan is approximately 1:1000. May be used as a baseline study. 30-50 of bone mass must be replaced for it to be positive. Plain fim correlates or CT/MRI are use to resolve questionable findings
    • CT and body coil MRI have no proven contemporary role in the staging of prostate cancer. Endorectal coil may provide additional staging resolution in patients with PSA values between 10 and 20 who have >50% of biopsy cores positive for cancer.
    • Bilateral pelvic lymph node dissection. Provides staging information in patients with high grade/stage disease with elevated serum PSA. Generally part of radical prostatectomy. Given stage shift in disease, frozen section less often employed in most cases. Can be performed laparoscopically as a separate procedure.
    • Multimodal staging. Multiple clinical factors can be analyzed for contribution prediction of pathologic stage or clinical outcome. Multivariable analysis, continuous nomograms, and neural networks can be employed.  For more on staging


    • Albertson PC, Hanley JA, Gleason DR, Barry MJ: Competing risk analysis of men aged 55 to 74 years at diagnosis managed conservatively for clinically localized prostate cancer. JAMA 280:975-980, 1998.
    • Cooney, K. A., J. D. McCarthy, et al. (1997). "Prostate cancer susceptibility locus on chromosome 1q: a confirmatory study." J Natl Cancer Inst 89(13): 955-9.
    • Devgan, S. A., B. E. Henderson, et al. (1997). "Genetic variation of 3 beta-hydroxysteroid dehydrogenase type II in three racial/ethnic groups: implications for prostate cancer risk." Prostate 33(1): 9-12.
    • Greenlee, R. T., T. Murray, et al. (2000). "Cancer statistics, 2000." CA Cancer J Clin 50(1): 7-33.
    • Jemal, A., T. Murray, et al. (2003). "Cancer statistics, 2003." CA Cancer J Clin 53(1): 5-26.
    • Kalapurakal, J. A., A. N. Jacob, et al. (1999). "Racial differences in prostate cancer related to loss of heterozygosity on chromosome 8p12-23." Int J Radiat Oncol Biol Phys 45(4): 835-40.
    • Makridakis, N., R. K. Ross, et al. (1997). "A prevalent missense substitution that modulates activity of prostatic steroid 5alpha-reductase." Cancer Res 57(6): 1020-2.
    • Makridakis, N. M., R. K. Ross, et al. (1999). "Association of mis-sense substitution in SRD5A2 gene with prostate cancer in African-American and Hispanic men in Los Angeles, USA." Lancet 354(9183): 975-8.
    • Naughton et al, 2000. Naughton CK, Miller DC, et al: A prospective randomized trial comparing 6 versus 12 prostate biopsy cores: impact on cancer detection. J Urol  2000; 164(2):388-392.
    • Pettaway, C. A., P. Troncoso, et al. (1998). "Prostate specific antigen and pathological features of prostate cancer in black and white patients: a comparative study based on radical prostatectomy specimens." J Urol 160(2): 437-42.
    • Platz, E. A., M. N. Pollak, et al. (1999). "Racial variation in insulin-like growth factor-1 and binding protein-3 concentrations in middle-aged men." Cancer Epidemiol Biomarkers Prev 8(12): 1107-10.
    • Ross, R. K., L. Bernstein, et al. (1992). "5-alpha-reductase activity and risk of prostate cancer among Japanese and US white and black males." Lancet 339(8798): 887-9.
    • Sakr, W. A., D. J. Grignon, et al. (1995). "Epidemiology of high grade prostatic intraepithelial neoplasia." Pathol Res Pract 191(9): 838-41.
    • Schroder et al, 1998. Schroder FH, van der Maas P, Beemsterboer P, et al: Evaluation of the digital rectal examination as a screening test for prostate cancer. Rotterdam section of the European Randomized Study of Screening for Prostate Cancer. J Natl Cancer Inst  1998; 90(23):1817-1823.
    • Smith, J. R., D. Freije, et al. (1996). "Major susceptibility locus for prostate cancer on chromosome 1 suggested by a genome-wide search." Science 274(5291): 1371-4.
    • Thompson IM, Pauler DK, Goodman PJ, Tangen CM, Lucia MS, Parnes HL, Minasian LM, Ford LG, Lippman SM, Crawford ED, Crowley JJ, Coltman CA Jr. Prevalence of prostate cancer among men with a prostate-specific antigen level < or =4.0 ng per milliliter. N Engl J Med. 2004 May 27;350(22):2239-46.
    • Tricoli, J. V., D. L. Winter, et al. (1999). "Racial differences in insulin-like growth factor binding protein-3 in men at increased risk of prostate cancer." Urology 54(1): 178-82.
    • Winter, D. L., A. L. Hanlon, et al. (2001). "Plasma levels of IGF-1, IGF-2, and IGFBP-3 in white and African-American men at increased risk of prostate cancer." Urology 58(4): 614-8.
    • Xu, J., D. Meyers, et al. (1998). "Evidence for a prostate cancer susceptibility locus on the X chromosome." Nat Genet 20(2): 175-9.
    Published April 14, 2015
  • Prostate Cancer for the Internist.

    In the United States, approximately 240,000 men are diagnosed annually with prostate cancer. Although effective treatment options are available for clinically localized cancer, the potential burdensome co-morbidities and attendant healthcare costs from over diagnosis and over treatment have escalated the discussion and controversy regarding appropriate screening, diagnosis, and optimal management of prostate cancer.

    Published December 30, 2015
  • Prostate Cancer in Primary Care.

    Prostate cancer is a common malignancy seen worldwide. The incidence has risen in recent decades, mainly fuelled by more widespread use of prostate-specific antigen (PSA) testing, although prostate cancer mortality rates have remained relatively static over that time period.

    Published August 20, 2018
  • Prostate Cancer Markers.

    Diagnostic biomarkers derived from blood, urine, or prostate tissue provide additional information beyond clinical calculators to determine the risk of detecting high-grade prostate cancer. Once diagnosed, multiple markers leverage prostate cancer biopsy tissue to prognosticate clinical outcomes, including adverse pathology at radical prostatectomy, disease recurrence, and prostate cancer mortality; however the clinical utility of some outcomes to patient decision making is unclear.

    Published September 7, 2018
  • Prostate Cancer Screening

    Prostate cancer screening refers to testing for disease in healthy, asymptomatic populations, where diagnosis is the identification of disease among individuals with signs or symptoms. The goal of screening is to improve overall health outcomes by identifying and treating disease at an earlier stage.

    • There is strong evidence that prostate cancer screening reduces the rates of advanced disease, but it remains controversial.  
    • The prostate-cancer mortality in the European Randomized Study of Screening for Prostate Cancer was recently updated with 2 additional years of follow-up.  Analyses after 2 additional years of follow-up confirmed previous finding that PSA-based screening significantly reduced mortality from prostate cancer but did not affect all-cause mortality.
    • The role for true prostate cancer screening is not proven. Absolute proof of screening is a decrease in the death rate of that cancer due to screening activity. Stage shift in prostate cancer and decrease in death rate statistics indirectly suggest a positive effect of PSA in disease detection. Prospective trials are continuing.
    • The American Cancer Society, American Radiological Association, and American Urological Association recommends early detection with an annual DRE and PSA beginning at age 50 for all men with a life expectancy greater than 10 years and age 45 for men of African American race and age 40 for men with a family history of prostate cancer. Those men with a serum PSA equal or greater to 0.6 ng/ml (the median PSA for that age group) should undergo yearly screening, whereas those with a value less than 0.6 ng/ml may have another interval PSA at age 45. The same rule applies at age 45. The American Cancer Society recommends that men thinking about prostate cancer screening should make informed decisions based on available information, discussion with their doctor, and their own views on the benefits and side effects of screening and treatment.
    • Digital Rectal Exam. More cancer is detected with the use of DRE and PSA than with either exam alone. With high penetrance of PSA use in younger patients however, abnormal DRE exams are much less common.
    • PSA. In general 5-8 percent of a screening population will have an abnormal DRE. A value between 4-10 ng/ml has a 15-30% chance of being positive. Values above 10 are associated with a positive biopsy in greater than two thirds of cases. PSA has a sensitivity of 80% and a specificity of 35-50%. False positive findings are common. The optimal upper limit of normal for PSA is controversial. Recent studies suggest that using a PSA cutoff of 2.5 ng/ml for men younger than 60 years may be more appropriate. A subset analysis of data from the Prostate Cancer Prevention Trial from men with serum PSA levels less than 4.0 ng/ml (2950 men) showed a prostate cancer incidence of 15.2%, with 15% of these being of Gleason score 7 or greater. The prostate cancer prevalence was 6.6% among men with a PSA level of =0.5 ng/ml, 10.1% among those with values of 0.6 to 1.0 ng/ml, 17.0% among those with values of 1.1 to 2.0 ng/ml, 23.9% among those with values of 2.1 to 3.0 ng/ml, and 26.9% among those with values of 3.1 to 4.0 ng/ml. These data suggest that using absolute values for triggering a biopsy may not be as important as assessing PSA velocity.
    • Free and complexed PSA. PSA may be found free in serum or bound to alpha -1-antichymotrypsin and alpha-2 macroglobin. Higher fraction of free PSA noted in benign disease. If percent free PSA is >25% the probability of a positive biopsy drops from 15-30 percent to 5-7%. Generally used in consideration for repeat biopsies. As a single test for screening, cPSA may improve specificity over total PSA and comparable specificity to free-to-total PSA for prostate cancer detection, and may reduce the number of unnecessary prostate biopsies in the 2.6-4.0 ng/mL tPSA range.
    • Precursor PSA (pPSA). PSA is secreted from the prostate luminal epithelial cells as pPSA, an inactive proenzyme containing a 7-amino acid pro-leader peptide and 237 amino acids of mature PSA. The pro-leader peptide is removed extracellularly to produce active, mature PSA. Since no pPSA forms have been found in seminal plasma, pPSA has been identified as a serum marker with greater cancer specificity. Using 1091 retrospective serum specimens of patients with a total PSA between 2 and 4 ng/ml, Catalona and colleagues recently showed that using a cutoff of pro- to free-PSA (percent pro-PSA) of 1.8% for recommending prostate biopsy detected 90% of cancers, including 16 of 16 extracapsular tumors and 28 of 29 tumors with a pathology Gleason score of 7 or greater, while avoiding 19% of unnecessary biopsies
      • PSA velocity. Several studies suggest that if the serum PSA increases greater than 0.75 g/mL per year the potential for prostate cancer is greater. Unfortunately, since PSA variability can be as high as 23.5 percent per reading, three separate readings 6 months apart are necessary to establish a true trend. In addition, no added benefit has been demonstrated in patients with a PSA level between 4 and 10 ng/mL. A recent study by D'Amico et al published in the New England Journal of Medicine suggested that an annual PSA velocity of 2 ng/ml or greater was independently associated with prostate cancer mortality after radical prostatectomy. Potentially this may serve as a marker for identifying patients who may be considered for novel neoadjuvant strategies before undergoing surgery.
      • Age adjusted PSA. Concept of raising PSA threshold in older patients and lowering it in younger patients. Data suggests normal PSA of 2.5 may be more appropriate in men under the age of 60. Many suggest lowering value for young men and maintaining 4.0 for older patients to minimize "miss rate" in this population
    • Screening bias. Length time bias consists of detecting a case at an earlier time in its history and suggesting a longer survival period from treatment, which is actually just a longer period of observation. Lead-time bias consists in part of selecting cases from a disease population with good survival traits and thus suggesting an apparent survival benefit that does not exist.
    • Beneficence. Does disease detection provide a benefit, or do side effects of therapy or the anxiety of false negative tests outweigh the benefit?
    • Screening costs. Can be significant, yet most estimates based on extremely high compliance rates. Elevated PSA detects clinically significant tumors and does not over detect microscopic pathological disease.


    • Albertson PC, Hanley JA, Gleason DR, Barry MJ: Competing risk analysis of men aged 55 to 74 years at diagnosis managed conservatively for clinically localized prostate cancer. JAMA 280:975-980, 1998.
    • Barry, 2009. Barry MJ: Screening for prostate cancer—the controversy that refuses to die. N Engl J Med  2009; 360(13):1351-1354.
    • Catalona WJ, Bartsch G, Rittenhouse HG, Evans CL, Linton HJ, Horninger W, Klocker H, Mikolajczyk SD.Serum pro-prostate specific antigen preferentially detects aggressive prostate cancers in men with 2 to 4 ng/ml prostate specific antigen. J Urol. 2004 Jun;171(6 Pt 1):2239-44.
    • D'Amico AV, Chen MH, Roehl KA, Catalona WJ. Preoperative PSA velocity and the risk of death from prostate cancer after radical prostatectomy. N Engl J Med. 2004 Jul 8;351(2):125-35.
    • Parsons JK, Brawer MK, Cheli CD, Partin AW, Djavan R.Complexed prostate specific antigen (PSA) reduces unnecessary prostate biopsies in the 2.6-4.0 ng/mL range of total PSA. BJU Int. 2004 Jul;94(1):47-50.
    • Schroder et al, 2012. Schroder FH, Hugosson J, Roobol MJ, ERSPC Investigatorset al:Prostate-cancer mortality at 11 years of follow-up. N Engl J Med 2012 Mar 15;366(11):981-90.
    • Schroder et al, 2009. Schroder FH, Hugosson J, Roobol MJ, et al: Screening and prostate-cancer mortality in a randomized European study. N Engl J Med  2009; 360(13):1320-1328.
    • Thompson IM, Pauler DK, Goodman PJ, Tangen CM, Lucia MS, Parnes HL, Minasian LM, Ford LG, Lippman SM, Crawford ED, Crowley JJ, Coltman CA Jr. Prevalence of prostate cancer among men with a prostate-specific antigen level < or =4.0 ng per milliliter. N Engl J Med. 2004 May 27;350(22):2239-46.
    • van der Cruijsen-Koeter et al, 2006. van der Cruijsen-Koeter IW, Roobol MJ, Wildhagen MF, et al: Tumor characteristics and prognostic factors in two subsequent screening rounds with four-year interval within prostate cancer screening trial, ERSPC Rotterdam. Urology  2006; 68(3):615-620.
    Published April 1, 2012
  • Prostate Cancer Screening and the Associated Controversy.

    Prostate cancer is the most common malignancy diagnosed in men and the second leading cause of cancer death for men in the United States. Widespread use of prostate-specific antigen (PSA) screening led to a decrease in mortality; however, PSA screening may have led to overdiagnosis and overtreatment of clinically insignificant cancers.

    Published September 24, 2015
  • Prostate Cancer Screening in Early Medicaid Expansion States.

    The Affordable Care Act of 2010 included a provision to expand Medicaid by 2014. Six states and jurisdictions elected to expand Medicaid early, before 2012. This provided a natural experiment to test the association between expanded insurance coverage and preventive service utilization, including prostate cancer screening.

    Published August 9, 2017
  • Prostate cancer screening: where are we now?

    Screening aims to identify prostate cancer at an early stage where curative treatment can reduce mortality. Given high false positive and false negative rates, however, the use of prostate-specific antigen (PSA) in screening has long been controversial.

    Published February 12, 2019
  • Prostate Health Index (PHI) improves prostate cancer detection at initial biopsy in Taiwanese men with PSA 4-10 ng/mL.

    In this study, we aimed to validate the Prostate Health Index (PHI) for the detection of prostate cancer (PCa). We prospectively enrolled patients aged 50-75 years with a serum prostate specific antigen (PSA) level of 4-10 ng/mL undergoing transrectal biopsy of the prostate between April 2016 and May 2017.

    Published July 31, 2018
  • Prostate specific antigen testing after radical prostatectomy: can we stop at 20 years?

    To examine the clinical features and outcomes associated with delayed biochemical recurrence after radical prostatectomy, specifically amongst men with over 20 years of follow-up.

    16,720 men underwent radical prostatectomy and 2,699 experienced biochemical recurrence.

    Published August 25, 2017
  • Prostate volume index and prostatic chronic inflammation predicted low tumor load in 945 patients at baseline prostate biopsy.

    To assess associations of prostate volume index (PVI), defined as the ratio of the volume of the central transition zone to the volume of the peripheral zone of the prostate and prostatic chronic inflammation (PCI) as predictors of tumor load by number of positive cores (PC) in patients undergoing baseline random biopsies.

    Published June 6, 2019
  • Prostate-specific antigen after neoadjuvant androgen suppression in prostate cancer patients receiving short-term androgen suppression and external beam radiotherapy: pooled analysis of four NRG Oncology RTOG randomized clinical trials.

    To validate if prostate specific antigen (PSA) level after neoadjuvant androgen suppression (neoAS) is associated with long-term outcome after neoAS and external radiation therapy (RT) with concurrent short-term AS in prostate cancer patients.

    Published April 12, 2019
  • Prostate-Specific Antigen Kinetics Following 5α-Reductase Inhibitor Treatment May Be a Useful Indicator for Repeat Prostate Biopsy.

    To evaluate parameters for determining repeat prostate biopsy in patients with 5α-reductase inhibitor (5ARI) treatment after initial negative biopsy.

    From January 2007 to December 2015, patients who underwent a repeat prostate biopsy after an initial negative biopsy were enrolled from multiple institutions.

    Published February 22, 2018
  • Prostate-specific antigen screening: An update of physician beliefs and practices.

    PSA testing for early detection of prostate cancer decreased dramatically following the 2012 PSA screening recommendation against routine screening of asymptomatic men. In an assessment of the screening behaviors of primary care providers, the majority (61%) of family medicine and internal medicine practitioners who responded to a 2016 DocStyles online survey (608 of 1003) recommended prostate-specific antigen (PSA) testing based on individual risk or other factors, rather than routinely screening all men for prostate cancer.

    Published August 18, 2017
  • Prostate-specific antigen velocity is not better than total prostate-specific antigen in predicting prostate biopsy diagnosis.

    OBJECTIVE - 1.) Identify whether prostate-specific antigen velocity improves the ability to predict prostate biopsy diagnosis. 2.) Test whether there is an increase in the predictive capability of models when Gleason 7 prostate cancers are separated into a 3+4 and a 4+3 group.

    Published August 5, 2015
  • Racial and Ethnic Variation in Time to Prostate Biopsy after an Elevated Screening Level of Serum PSA.

    To examine the racial and ethnic variation in time to prostate biopsy after an elevated screening level of serum prostate-specific antigen (PSA).

    Male members of the Kaiser Permanente of Southern California health plan, 45 years of age or older, with no history of prostate cancer or a prostate biopsy and at least one elevated screening level of serum PSA between January 1(st), 1998 and December 31(st), 2007 were retrospectively identified (n=59,506).

    Published June 20, 2016
  • Radium-223 in patients with metastatic castration-resistant prostate cancer: Efficacy and safety in clinical practice.

    Radium-223 has improved overall survival (OS) and reduced symptomatic skeletal events (SSE) in patients with metastatic castration-resistant prostate cancer (mCRPC) and bone metastases (ALSYMPCA trial).

    Published March 28, 2019
  • Real-time monitoring of tumor progression and drug responses in a preclinical mouse model of prostate cancer.

    Monitoring disease progression through imaging is playing an increasingly important role in the treatment of prostate cancer. Here, we report that primary mouse prostate cancer cell lines stably expressing luciferase and tumor biomarkers can be monitored through bioluminescence imaging along with assays of serum biomarkers and immune function.

    Published April 24, 2016
  • Reassessment of the risk factors for biochemical recurrence in D'Amico intermediate-risk prostate cancer treated using radical prostatectomy.

    To assess the risk factors for biochemical recurrence in D'Amico intermediate-risk prostate cancer patients treated using radical prostatectomy.

    We retrospectively reviewed the medical records of 1268 men with prostate cancer treated using radical prostatectomy without neoadjuvant therapy.

    Published September 1, 2015
  • Recent decline in prostate cancer incidence in the United States, by age, stage, and Gleason score.

    Prostate cancer incidence is sensitive to screening practices, however the impact of recent screening recommendations from the United States Preventative Services Task Force on prostate cancer incidence by age, stage, race, and Gleason score is unknown.

    Published December 8, 2015
  • Relationship of age, prostate-specific antigen, and prostate volume in Indonesian men with benign prostatic hyperplasia.

    To investigate the relationship between age, prostate specific antigen (PSA), and prostate volume (PV) in Indonesian men with histologically proven benign prostatic hyperplasia.

    Data were generated from our BPH database from June 1994 until December 2013.

    Published July 11, 2016
  • Renal-type clear cell carcinoma of prostate: A case report and review of literature.

    We analyzed the clinicopathological features of renal-type clear cell carcinoma (RTCCC) in the prostate and its diagnosis according to the example in our hospital and review of the literature. Clinicopathological features of RTCCC in the prostate were observed in a patient from our hospital combining with a review of the literature.

    Published July 18, 2018
  • Revisiting Prostate Cancer Screening Practices Among Vermont Primary Care Physicians.

    The objective of this study was to assess the prostate cancer screening practices of Vermont primary care physicians and compare them with a prior study in 2001. An electronic survey was created and emailed to all currently practicing primary care physicians in Vermont.

    Published June 21, 2017
  • Risk of prostate cancer in men with spinal cord injury: A systematic review and meta-analysis.

    A lower risk of prostate cancer has been reported in men with spinal cord injury (SCI) as compared to that observed in able-bodied subjects. As injury-related consequences can have opposite effects on prostate pathophysiology, this meta-analysis aimed to (1) establish the existence/quantify the extent of decreased prostate cancer risk following SCI and (2) find out if there is any statistically significant difference in prostate-specific antigen (PSA) levels between SCI and able-bodied subjects.

    Published July 4, 2018
  • Role of PI-RADSv2 with multiparametric MRI in determining who needs active surveillance or definitive treatment according to PRIAS.

    To evaluate the role of Prostate Imaging Reporting and Data System v. 2 (PI-RADSv2) in triaging patients with prostate cancer according to Prostate Cancer Research International: Active Surveillance (PRIAS).

    Published November 4, 2016
  • Screening for prostate cancer: History, evidence, controversies and future perspectives toward individualized screening.

    Differences in the incidence and mortality rate of prostate cancer between the USA and Japan have been decreasing over time, and were only twofold in 2017. Therefore, countermeasures against prostate cancer could be very important not only in Western countries, but also in developed Asian countries.

    Published June 19, 2019
  • Secondary prostate cancer screening outcomes by race in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Screening Trial.

    Despite disparities in prostate cancer incidence and mortality rates between black and white men, there is still insufficient data available to assess potential differences in the benefits and harms of prostate cancer screening by race.

    Published April 28, 2018
  • SERS-Based Pump-Free Microfluidic Chip for Highly Sensitive Immunoassay of Prostate-Specific Antigen Biomarkers.

    Highly sensitive analysis of cancer biomarkers demonstrates an important impact in early diagnosis and therapies of cancer. A novel surface-enhanced Raman scattering (SERS) based immunoassay using microfluidic technique was reported for rapid analysis of prostate-specific antigen (PSA) biomarker.

    Published March 28, 2019
  • Shifting the Paradigm of Testosterone Replacement Therapy in Prostate Cancer.

    Historically, testosterone and prostate cancer have been demonstrated to have a positive association leading providers to forgo testosterone replacement therapy (TRT) in men with concurrent histories of hypogonadism and prostate cancer.

    Published April 9, 2018
  • Single Lesion on Prostate-specific Membrane Antigen-ligand Positron Emission Tomography and Low Prostate-specific Antigen Are Prognostic Factors for a Favorable Biochemical Response to Prostate-specific Membrane Antigen-targeted Radioguided Surgery in Recurrent Prostate Cancer.

    Prostate-specific membrane antigen (PSMA)-ligand positron emission tomography (PET) allows detection of metastatic prostate cancer (PC) lesions at low prostate-specific antigen (PSA) values. To facilitate their intraoperative detection during salvage surgery, we recently introduced PSMA-targeted radioguided surgery (RGS).

    Published May 14, 2019
  • Six Weeks of Fluoroquinolone Antibiotic Therapy for Patients with Elevated Serum PSA is not Clinically Beneficial: A Randomized Controlled Clinical Trial.

    OBJECTIVE - To evaluate asymptomatic men with elevated serum prostate specific antigen (PSA) to determine whether a six-week course of fluoroquinolone antibiotics lowers serum PSA and affects recommendations for prostate biopsy.

    Published January 24, 2016
  • Superporous Poly(ethylene glycol) Diacrylate Cryogel with a Defined Elastic Modulus for Prostate Cancer Cell Research.

    The physical and mechanical properties of the tumor microenvironment are crucial for the growth, differentiation and migration of cancer cells. However, such microenvironment is not found in the geometric constraints of 2D cell culture systems used in many cancer studies.

    Published June 1, 2016
  • Testing of a Tool for Prostate Cancer Screening Discussions in Primary Care.

    As prostate cancer (PCa) screening decisions often occur in outpatient primary care, a brief tool to help the PCa screening conversation in busy clinic settings is needed.

    A previously created 9-item tool to aid PCa screening discussions was tested in five diverse primary care clinics.

    Published July 19, 2018

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