Hw. Wechsel et al., The behavior of prostate specific antigen (PSA) and free-PSA (f-PSA) underantihormonal therapy, ANTICANC R, 20(6D), 2000, pp. 4993-4994
Within a few weeks if therapy of the hormone sensitive, advanced prostate c
ancer (PCa) is sufficient, there will be a PSA-decrease to testify to the r
egression of the PCa. Free-PSA (f-PSA) is used for the differential diagnos
is of the PCa. Values under 25% f-PSA in proportion to complete-PSA show th
e possibility of the existence of a Pea. The aim of the work was to study t
he behavior of f-PSA under hormonal ablation. Initial PSA and f-PSA was exa
mined (RIA) in 76 patients (average age = 72.8 yrs, old) with advanced PCa.
(metastases) proven by bone scintigraphy and/or computed tomography. Durin
g hormonal therapy (LHRH-agonists) monthly PSA and f-PSA abundance were exa
mined. The percent amount off;PSA was calculated and documented for at leas
t 6 months. The initial PSA-values were 43.6 +/- 17.3, the f-PSA were 13.4%
+/- 8.9. Under antihormonal therapy PSA decreased (while f-PSA increased)
and after a period of 1 month the values were 27.4 +/- 14.9 (17.4% +/- 12.3
), after 3 months 18.1 +/- 11.3 (24,5% +/- 9.9), after 6 months 7.9 +/- 6.8
(26.1 +/- 10.6). During the 6 months of hormonal ablation PSA-values conti
nuously declined, while, after the first 3 months, f-PSA-values showed a be
havior similar to benign hyperplasia of prostate. The therapeutic efficienc
y of the antihormonal therapy is clearly shown through f-PSA and PSA. There
are no timely advantages between the two markers. Further investigations w
ill show whether hormone insensitive PCa can be recognized quicker through
f-PSA than from an ina ease in PSA.