Skip to main content
SpringerLink
Log in

The Phenomenon of PSA Bounce After Radiation Therapy

  • Chapter
  • First Online:
Prostate Cancer: A Comprehensive Perspective

Abstract

Following radiotherapy for prostate cancer, the serum PSA level will fall to reach a nadir several years later. PSA bounce refers to a benign intermittent PSA rise prior to subsequent decrease. It has been observed in all forms of primary radiotherapy strategies, most recently in stereotactic radiation where it was noted in 29 % of patients. Comparison of published data is difficult due to variations in definitions, populations studied, and types of treatment. The majority of studies, however, do not reveal a relationship between PSA bounce and biochemical control. The only consistent pretreatment factor that appears to predict for PSA bounce is patient age at treatment. The updated ASTRO definition of biochemical failure following radiotherapy treatment (PSA nadir plus 2 ng/mL) aims to reduce the false-positive rate due to bounce but is not foolproof as bounces will still occur above this value. Pre-intervention counseling and judicious timing and frequency of PSA-testing posttreatment may help relieve the anxieties associated with PSA bounce.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 229.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Pollack A, Zagars GK, Starkschall G, et al. Prostate cancer radiation dose response: results of the M. D. Anderson phase III randomized trial. Int J Radiat Oncol Biol Phys. 2002;53(5):1097–105.

    Article  PubMed  Google Scholar 

  2. Wallner KE, Blasko J, Dattoli MJ. Evaluating cancer status. In: Wallner KE, Blasko J, Dattoli MJ, editors. Prostate brachytherapy made complicated. Seattle: SmartMedicine Publishing; 1997. p. 11–4.

    Google Scholar 

  3. King CR, Brooks JD, Gill H, Pawlicki T, Cotrutz C, Presti Jr JC. Stereotactic body radiotherapy for localized prostate cancer: interim results of a prospective phase II clinical trial. Int J Radiat Oncol Biol Phys. 2009;73(4):1043–8.

    Article  PubMed  Google Scholar 

  4. Rosser CJ, Kuban DA, Levy LB, et al. Prostate specific antigen bounce phenomenon after external beam radiation for clinically localized prostate cancer. J Urol. 2002;168(5):2001–5.

    Article  PubMed  CAS  Google Scholar 

  5. Hanlon AL, Pinover WH, Horwitz EM, Hanks GE. Patterns and fate of PSA bouncing following 3D-CRT. Int J Radiat Oncol Biol Phys. 2001;50(4):845–9.

    Article  PubMed  CAS  Google Scholar 

  6. Horwitz EM, Levy LB, Thames HD, et al. Biochemical and clinical significance of the posttreatment prostate-specific antigen bounce for prostate cancer patients treated with external beam radiation therapy alone: a multi-institutional pooled analysis. Cancer. 2006;107(7):1496–502.

    Article  PubMed  CAS  Google Scholar 

  7. Sheinbein C, Teh BS, Mai WY, Grant W, Paulino A, Butler EB. Prostate-specific antigen bounce after intensity-modulated radiotherapy for prostate cancer. Urology. 2010;76(3):728–33.

    Article  PubMed  Google Scholar 

  8. Pickles T. Prostate-specific antigen (PSA) bounce and other fluctuations: which biochemical relapse definition is least prone to PSA false calls? An analysis of 2030 men treated for prostate cancer with external beam or brachytherapy with or without adjuvant androgen deprivation therapy. Int J Radiat Oncol Biol Phys. 2006;64(5):1355–9.

    Article  PubMed  Google Scholar 

  9. Crook J, Gillan C, Yeung I, Austen L, McLean M, Lockwood G. PSA kinetics and PSA bounce following permanent seed prostate brachytherapy. Int J Radiat Oncol Biol Phys. 2007;69(2):426–33.

    Article  PubMed  CAS  Google Scholar 

  10. Mitchell DM, Swindell R, Elliott T, Wylie JP, Taylor CM, Logue JP. Analysis of prostate-specific antigen bounce after I(125) permanent seed implant for localised prostate cancer. Radiother Oncol. 2008;88(1):102–7.

    Article  PubMed  Google Scholar 

  11. Bostancic C, Merrick GS, Butler WM, et al. Isotope and patient age predict for PSA spikes after permanent prostate brachytherapy. Int J Radiat Oncol Biol Phys. 2007;68(5):1431–7.

    Article  PubMed  CAS  Google Scholar 

  12. Patel C, Elshaikh MA, Angermeier K, et al. PSA bounce predicts early success in patients with permanent iodine-125 prostate implant. Urology. 2004;63(1):110–3.

    Article  PubMed  Google Scholar 

  13. Ciezki JP, Reddy CA, Garcia J, et al. PSA kinetics after prostate brachytherapy: PSA bounce phenomenon and its implications for PSA doubling time. Int J Radiat Oncol Biol Phys. 2006;64(2):512–7.

    Article  PubMed  CAS  Google Scholar 

  14. Critz FA, Williams WH, Levinson AK, et al. Prostate specific antigen bounce after simultaneous irradiation for prostate cancer: the relationship to patient age. J Urol. 2003;170(5):1864–7.

    Article  PubMed  Google Scholar 

  15. Stock RG, Stone NN, Cesaretti JA. Prostate-specific antigen bounce after prostate seed implantation for localized prostate cancer: descriptions and implications. Int J Radiat Oncol Biol Phys. 2003;56(2):448–53.

    Article  PubMed  Google Scholar 

  16. Das P, Chen MH, Valentine K, et al. Using the magnitude of PSA bounce after MRI-guided prostate brachytherapy to distinguish recurrence, benign precipitating factors, and idiopathic bounce. Int J Radiat Oncol Biol Phys. 2002;54(3):698–702.

    Article  PubMed  Google Scholar 

  17. Merrick GS, Butler WM, Wallner KE, Galbreath RW, Anderson RL. Prostate-specific antigen spikes after permanent prostate brachytherapy. Int J Radiat Oncol Biol Phys. 2002;54(2):450–6.

    Article  PubMed  Google Scholar 

  18. Critz FA, Williams WH, Benton JB, Levinson AK, Holladay CT, Holladay DA. Prostate specific antigen bounce after radioactive seed implantation followed by external beam radiation for prostate cancer. J Urol. 2000;163(4):1085–9.

    Article  PubMed  CAS  Google Scholar 

  19. Crook J, Malone S, Perry G, Bahadur Y, Robertson S, Abdolell M. Postradiotherapy prostate biopsies: what do they really mean? Results for 498 patients. Int J Radiat Oncol Biol Phys. 2000;48(2):355–67.

    Article  PubMed  CAS  Google Scholar 

  20. Consensus statement: guidelines for PSA following radiation therapy. American Society for Therapeutic Radiology and Oncology Consensus Panel. Int J Radiat Oncol Biol Phys. 1997;37(5):1035–41.

    Google Scholar 

  21. Roach III M, Hanks G, Thames Jr H, et al. Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference. Int J Radiat Oncol Biol Phys. 2006;65(4):965–74.

    Article  PubMed  Google Scholar 

  22. Prestigiacomo AF, Stamey TA. Physiological variation of serum prostate specific antigen in the 4.0 to 10.0 ng/ml. range in male volunteers. J Urol. 1996;155(6):1977–80.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Southend University Hospital NHS Foundation Trust, Prittlewell Chase, Westcliff-on-Sea, Essex, SS0 0RY, UK

    Peter Acher M.A., FRCS (Urol), Ph.D.

  2. Department of Urology, Urology Centre, Guy’s and St. Thomas’ Hospitals, 1st Floor Southwark Wing, Guy’s Hospital, St. Thomas’ Street, London, SE1 9RT, UK

    Rick Popert M.S., FRCS (Urol)

Authors
  1. Peter Acher M.A., FRCS (Urol), Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rick Popert M.S., FRCS (Urol)
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peter Acher M.A., FRCS (Urol), Ph.D. .

Editor information

Editors and Affiliations

  1. New York Presbyterian Hospital, Brady Urologic Health Center, Weill Cornell Medical Center, East 68th Street 525, New York, 10021, New York, USA

    Ashutosh Tewari

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag London

About this chapter

Cite this chapter

Acher, P., Popert, R. (2013). The Phenomenon of PSA Bounce After Radiation Therapy. In: Tewari, A. (eds) Prostate Cancer: A Comprehensive Perspective. Springer, London. https://doi.org/10.1007/978-1-4471-2864-9_68

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-2864-9_68

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-2863-2

  • Online ISBN: 978-1-4471-2864-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation