Molecular Markers for Prostate Cancer
Engelstein, D.
Harefuah 156(5): 318-321
2017
ISSN/ISBN: 0017-7768 PMID: 28551905 Document Number: 694154
Prostate cancer (PCa) is the most frequent malignancy and the second cause of death from malignancy in men in the Western world. Prostatic Specific Antigen (PSA) has been widely used as a possible marker for PCa for the last three decades, but its significant limitations are known, especially its lack of an exact cutoff level for diagnosis of PCa. Imprudent use of PSA has led to over-diagnosis and over-treatment in men with low risk PCa, not significant for survival. Therefore, researchers are looking for better and more accurate markers for diagnosis, treatment decisions and follow-up. In this article we review the various markers for PCa, especially two recent ones, their development process and validation results. The two markers are molecularbased and may provide an accurate and practical answer to important clinical questions: (1) In which patient with negative prostate biopsy should we repeat the biopsy? Can we locate the region of major risk? (2) Which patient diagnosed with low to moderate risk of PCa needs immediate treatment vs. active surveillance?