Question

Define biochemical recurrence after radical prostatectomy and after radiation therapy for carcinoma prostate.

Hint:

In both cases, rising PSA levels should prompt further evaluation, including imaging and possible biopsy, to assess the extent of recurrence.

Answer 1

Biochemical recurrence refers to an increase in prostate-specific antigen (PSA) levels after treatment for prostate cancer, indicating potential recurrence of cancer. The definition differs slightly between patients who have undergone radical prostatectomy and those who have received radiation therapy.
Step 1: After Radical Prostatectomy:
Biochemical recurrence after radical prostatectomy is typically defined by a PSA level of greater than 0.2 ng/mL with a confirmatory rise in subsequent measurements. This rise suggests the presence of residual cancer cells that were not removed during the surgery.
Step 2: After Radiation Therapy:
After radiation therapy, biochemical recurrence is generally defined as a rise in PSA levels above the nadir (lowest point) after treatment. The Phoenix definition, which is commonly used, considers a PSA rise of 2 ng/mL above the nadir as indicative of recurrence.