Contribution of Bone Scintigraphy, Prostatic Acid Phosphatase and Prostate-Specific Antigen to the Monitoring of Prostatic Cancer

Abstract

Changes in the serial measurements of serum prostatic acid phosphatase (PAP), and prostatic specific antigen (PSA) have been compared against changes in serial bone scans in 120 patients with prostatic cancer. Of 54 patients who presented with negative bone scans 10 developed skeletal metastases, the PAP and PSA levels were rising in 5 and 9 of these patients, respectively. Local progression occurred in a further 9 patients in whom PAP was rising in 8 and PSA in all 9. In the 66 patients with previously documented skeletal metastases bone scan evidence of progression was seen in 36. At the time of the first evidence of progression PAP was rising in 20 (55%) and PSA was rising in 26 (72%). In 4 patients neither marker was raised at the time of first evidence of progression. We discuss the value of ‘routine’ serial bone scintigraphy in monitoring patients with prostatic cancer.

Correlation between bone scans and serum levels of osteocalcin, prostate‐specific antigen, and prostatic acid phosphatase in monitoring patients with disseminated cancer of the prostate

“…Two comments have to be made to clarify these data. First, PSA and PAP values are markers of the overall tumor load, and a significant fall in their level usually indicates some response to treatment [8,22]. However, simultaneous assessment of these parameters reveals a higher rate of OC elevation in responding patients compared to the rate of decline of previously substantially elevated PSA and PAP levels (above 80 ng/ml and 50 ng/ml, respectively).…”

“…The normal ranges of blood PSA, PAP, and OC concentrations, as detected by these protocols, were 0-2.5 ng/ml, 0-2 ng/ml, and 3.5-1 1.5 ng/ml, respectively. According to the published reports [10,14] and our more recent unpublished data, the appropriate normal range for the PSA test is established as 0-10 ng/ml. However, PSA concentrations measured by RIA kits coming from different companies cannot be compared due to reported significant differences in numerical values obtained on the same sera [ 151.…”

Routine Estimation of Prostate Specific Antigen Prior to Clinic Attendance in Patients with Symptoms of Bladder Outlet Obstruction

“…The role of PSA in the staging of prostate cancer is less clear. Radioisotope bone scan remains the gold standard in the staging of prostate cancer at the time of initial presentation (O'Donoghue et al, 1978;Hetherington et al, 1988). In this study the low specificity makes serum PSA an inadequate substitute for an initial bone scan.…”

Prostatic Specific Antigen and the Prediction of Prognosis in Metastatic Prostatic Cancer

“…Hetherington et a/. 9 reported that in 36 patients showing evidence of an increased activity in sequential bone scans, 26 of 36 (72%) had an increased PSA and 20 of 36 (55%) had an increased acid phosphatase level. At the time of bone progression 29 of 36 (80.5%) had a PSA > 10 ng/ml.…”