Biochemical Recurrence in Prostate Cancer — Tilting the Scale

The state of biochemical recurrence in prostate cancer is one in which rising serum prostate-specific antigen (PSA) levels point to the existence of disease that remains radiographically invisible on computed tomography and technetium-99m bone scans. Because most prostate cancers have a prolonged natural history and largely affect older men with many competing causes of death, a sizable proportion of patients will never suffer or die from their metastases.1,2 For such patients, cancer therapies can only result in harm. Still, many biochemical recurrences are harbingers of prostate cancer–related morbidity and mortality, prompting some practitioners to use androgen-deprivation therapy (ADT) to curtail . . .