Is prostate-specific antigen still the best tumor marker for prostate cancer?

Abstract

PSA has been utilized for more than a decade. Since the overwhelming benefit of PSA, the previous markers for prostate cancer have been abandoned. Even though PSA is no more an organ specific agent, its function as an organ specific marker remains in all clinical situations. PSA is significantly involved not only in screening for early detection but also in all clinical spectrums of prostate cancer. Never before has the tumor marker played such a significant role in all purposes of clinical utilization for prostate cancer as PSA has. The answer to the title of this article is absolutely positive. Nevertheless, the following question of whether PSA has an impact in decreasing the mortality rate of patients with prostate cancer is yet to be answered. In Siriraj Hospital, though PSA has been available since 1991, the majority of patients registered with the advanced stage of disease and their treatment outcomes are not always satisfactory. Since the prognoses of the patients with an early stage of disease appear very good, to improve the mortality of Thai patients with prostate cancer, screening using PSA for early detection should be introduced and widely used.