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The Earlier the Better

Mitchell S. Anscher, MD

JAMA. 2004;291:1380-1382.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Adenocarcinoma of the prostate is the most commonly diagnosed malignancy in men in the United States, with 220 900 new cases and 28 900 deaths from the disease reported in 2003.¹ Despite the widespread use of serum prostate-specific antigen (PSA) to screen for prostate cancer in this country, approximately 25% of men treated with radical prostatectomy for tumors presumed localized to the prostate will be found to have extension of cancer beyond the capsule of the gland.² These men are at high risk for subsequent recurrence of their disease.

Following radical prostatectomy, PSA should become undetectable within a few weeks; if the patient is cured, PSA should remain undetectable for the rest of his life. Currently, for the vast majority of men treated for prostate cancer, the first sign of recurrence is an increasing PSA level without clinical or radiographic evidence of overt tumor—the so-called "biochemical" recurrence. In . . . [Full Text of this Article]

Author Affiliatons: Department of Radiation Oncology, Duke University Medical Center, Durham, NC.

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