Question
In a follow-up case of prostate cancer, what needs to be checked?
| A. |
Alkaline phosphatase
|
| B. |
PSA
|
| C. |
Testosterone
|
| D. |
Acid phosphatase
|
Show Answer
|
Correct Answer � B
Explanation
|
|
PSA (Prostate-Specific Antigen) is the most important tumor marker for diagnosis & follow-up of prostate cancer.
– After definitive treatment (e.g., prostatectomy, radiotherapy), PSA should fall to undetectable or very low levels.
– A rising PSA signals:
• Biochemical recurrence
• Progression or metastasis
• Treatment failure
– PSA kinetics (doubling time, velocity) help gauge recurrence aggressiveness and guide management decisions.
Incorrect Options:
– A. Alkaline phosphatase:
• May ↑ if bone metastasis occurs
• Not specific & not routinely used for monitoring treatment response
• Adjunct only when bone involvement suspected, not primary follow-up marker
– C. Testosterone:
• Checked during hormonal therapy to confirm castrate levels
• Not a marker of cancer progression itself
– D. Acid phosphatase:
• Used before PSA availability
• Less sensitive & specific than PSA
• Rarely used now in practice
