Are PSA Tests Necessary in the Follow-Up After Prostate Cancer Treatment?

2014 A study presented at the meeting organized by the American Society of Clinical Oncology (ASCO) showed that PSA tests provide no significant benefit in monitoring the recurrence of prostate cancer after treatment; on the contrary, these tests cause significant stress and anxiety in patients.

Follow-up after treatment is an issue of great importance in both prostate cancer and other types of cancer, just as treatment of the disease itself is. Examinations and tests performed during the follow-up period may provide an opportunity for early intervention if recurrence occurs and may enable the disease to be brought under control before it spreads. However, these tests also cause significant stress in patients. The possibility of an unfavorable result after each test is a cause of serious anxiety for patients and a significant decrease in their quality of life. At this point, it is useful to assess the benefits and risks of the tests performed. In addition to the stress these tests cause in patients, it is necessary to evaluate whether they provide a significant survival advantage.

PSA tests are currently the most commonly used method for diagnosing prostate cancer and monitoring patients after treatment. PSA (prostate-specific antigen) is a protein produced by prostate cells. Measuring the level of this protein in the blood is used to detect prostate cancer and other noncancerous prostate problems. PSA tests are also used to monitor the disease after treatment, and if PSA levels are found to be elevated to a concerning degree, androgen deprivation therapy is initiated without delay. However, a study presented at the ASCO meeting recently found no significant difference in survival between starting androgen deprivation therapy as soon as PSA levels rise and starting it after symptoms of the disease appear. Based on this, it was stated that PSA tests do not provide a significant benefit in monitoring the risk of cancer recurrence in these patients.

In this study, 2022 patients followed after treatment were divided into 2 groups. In one of the groups, treatment was started as soon as PSA levels rose, while in the other, it was started when symptoms appeared. The groups were followed for approximately 53 months. When the results were examined, only a %5 survival difference was observed in the group in which treatment was started immediately when PSA levels rose. Based on these results, it was concluded that the use of PSA tests is unnecessary in the follow-up after prostate cancer treatment.

In conclusion, this study, which indicates that PSA tests are unnecessary in the follow-up after prostate cancer treatment, represents an important development that may help improve the post-treatment quality of life of patients who live with constant concern about their PSA levels and experience significant stress regarding this issue. It has once again reminded the scientific community that, in cancer care, not only diagnosis and treatment but also patients’ quality of life afterward is an important issue that should be monitored.