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A blood protein made by the prostate; raised levels prompt further tests, and falling levels show treatment is working.
Answer a few questions from a report and read the guideline statement that applies, quoted word for word with its source. Educational aids to prepare for an appointment, not advice.
Screening test with proven mortality reduction (ERSPC ~20% at 16 years) but substantial overdiagnosis; now paired with MRI and risk-adapted intervals. In treated disease, PSA kinetics (doubling time, PSA50/PSA90 response, nadir) are the everyday response measure, though not a validated surrogate for survival in mCRPC.
The glossary entry explains the word; the readout page carries the scoring rule, the thresholds approvals use, the companion diagnostics and the tests.
The first randomised evidence that the order in which prostate cancer treatments are given changes how long they work, independently of which treatments they are. It is also a rare trial in which quality of life pointed one way and the primary endpoint pointed nowhere.
The trial behind the second PARP inhibitor licensed in prostate cancer, and the evidence that a somatic BRCA alteration predicts response as well as an inherited one. Together with TOPARP-A it is why tumour as well as germline sequencing is recommended in metastatic disease.
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.
The limit of what a prostate scan can be asked to do. It is a good triage test for whether to biopsy and a poor map of where every tumour is, which matters for anyone being offered treatment to part of the gland or follow-up by imaging alone.
A demonstration that a drug that has stopped working can be made to work again by changing the environment the tumour has adapted to, rather than by changing the drug. It is the strongest clinical evidence in prostate cancer for treating resistance as something reversible.
The current shape of the screening question in the United States, and the best short statement of the trade-off in numbers a man can weigh. The three-to-one ratio between metastatic cases prevented and deaths prevented is also the argument for using metastatic presentation, not mortality, to judge a screening programme sooner.
The trial that made observation a defensible choice for low-risk prostate cancer found by a blood test, and that supplied the number a man needs when weighing surgery: the progression it prevents is mostly progression on a scan or a blood test, and the harms it causes are felt every day.
The evidence that put a scan in front of the biopsy. It reduces the number of men who are biopsied at all, reduces the number of harmless cancers found, and increases the number of dangerous ones, which is the only combination that improves a screening pathway on both sides at once.
Shares ERSPC (European Randomized Study of Screening for Prostate Cancer), PROMIS, PIVOT (Prostate Cancer Intervention Versus Observation Trial), Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate.
Shares USPSTF 2012: screening for prostate cancer, recommendation statement (grade D), Prostate cancer diagnosis and treatment after the introduction of prostate-specific antigen screening, 1986 to 2005, Lead time and overdiagnosis in prostate-specific antigen screening: importance of methods and context, PIVOT: follow-up of prostatectomy versus observation for early prostate cancer.
Shares Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate, SWOG 9916: docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer, Abiraterone in metastatic prostate cancer without previous chemotherapy, USPSTF 2012: screening for prostate cancer, recommendation statement (grade D).
Shares Prolaris, Cambridge Prognostic Group (CPG 1 to 5), PSA kinetics: PSA doubling time and PSA density, Detection of individual prostate cancer foci via multiparametric magnetic resonance imaging.
Shares PROSTVAC, PROSPECT, Prostate Cancer Foundation (PCF), SWOG 9916: docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer.
Shares USPSTF 2012: screening for prostate cancer, recommendation statement (grade D), Measurement of prostate-specific antigen in serum as a screening test for prostate cancer, Prostate cancer diagnosis and treatment after the introduction of prostate-specific antigen screening, 1986 to 2005, Lead time and overdiagnosis in prostate-specific antigen screening: importance of methods and context.
Shares GÖTEBORG-2 (MRI-based prostate cancer screening), Polygenic risk score (PRS), Number needed to screen (and number needed to diagnose), PI-RADS (Prostate Imaging Reporting and Data System).
Shares GÖTEBORG-2 (MRI-based prostate cancer screening), PSA density, PSA kinetics: PSA doubling time and PSA density, Ductal adenocarcinoma of the prostate.