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PSA rising again after surgery or radiation, usually years before anything shows on a scan.
Biochemical recurrence is a rising PSA after treatment for prostate cancer, usually years before anything is visible on a scan. It is defined as a PSA of 0.2 ng/mL or more after prostatectomy, or a rise of 2 ng/mL above the nadir after radiation. PSMA PET, with agents such as fluciclovine F-18 and Illuccix, can now find the recurrent disease at very low PSA levels in most men, opening the way to salvage radiation or metastasis-directed therapy. The EMBARK trial, reported in 2023, showed that enzalutamide with or without androgen deprivation delays metastasis in high-risk recurrence defined by a short PSA doubling time. The term is linked from the PSA entry and from ideas on PSMA-PET-guided metastasis-directed therapy and on localising residual disease.
Showing the technology this term belongs to: PSMA PET.
The glossary entry explains the word; the readout page carries the scoring rule, the thresholds approvals use, the companion diagnostics and the tests.
It is the evidence behind using PSMA PET when PSA rises after treatment, and it quantifies the limit that matters most: below PSA 0.5 ng/mL, where salvage radiotherapy works best, the scan is negative in nearly two men in three, so a negative scan is not a reason to wait.
It is the definitive negative result for the commonest genomic alteration in this disease. A man told his tumour carries the TMPRSS2-ERG fusion should be told plainly that it does not make his cancer more dangerous.
The origin of the blood test that defines how prostate cancer is found, monitored and declared to have recurred. Its strength was always monitoring a known cancer; the problems began when the same test was used to look for cancer in men who had no symptoms.
Shares Extraprostatic extension and seminal vesicle invasion, EORTC 22911, RAVES (TROG 08.03/ANZUP), SWOG 8794.
Shares Extraprostatic extension and seminal vesicle invasion, EORTC 22911, ORIOLE, RAVES (TROG 08.03/ANZUP).
Shares RAVES (TROG 08.03/ANZUP), SWOG 8794, ARTISTIC meta-analysis, GETUG-AFU 16.
Shares EMBARK, GETUG-AFU 16, RADICALS-RT, Localised prostate cancer, high and very high risk.
Shares ORIOLE, STOMP, PSMA PET, Prostate cancer.
Shares Extraprostatic extension and seminal vesicle invasion, Metastasis-free survival (MFS), Localised prostate cancer, high and very high risk, PSMA PET.
Shares ORIOLE, PSMA-PET-guided metastasis-directed therapy as a curative strategy in oligorecurrent prostate cancer, STOMP, When the blood test is positive, hunt for the lesion with sensitive imaging.
Shares EMBARK, Metastasis-free survival (MFS), Prostate cancer.