Monitoring of prostate cancer patients: Guidelines and current practice

Objectives: This review paper focuses on monitoring of patients with prostate cancer (PCa) after initiating hormone therapy and discusses the risk of potential side-effects. Methods: This report is based on a presentation during a satellite symposium held at the European Association of Urology (EAU) 2007 Annual Congress in Berlin, Germany. Results: The assessment of serum prostate-specific antigen (PSA) levels is still the most widely used practice for PCa screening and remains important for follow-up after hormonal treatment. Serum testosterone levels should be determined to make sure that castrate levels are reached and may help in predicting return of sexual function after cessation of hormone therapy. Other promising markers used for monitoring PCa patients are osteoprotegerin and bone-specific alkaline phosphatase. However, patients receiving long-term hormone therapy are at an increased risk of acute and chronic side-effects, and therefore, careful monitoring is needed. Furthermore, lifestyle changes may be beneficial for preventing bone complications and metabolic syndrome in PCa patients receiving hormone therapy. Conclusions: These data indicate that PSA is still the most important marker for monitoring PCa patients after they have received hormone therapy. In addition, measuring serum testosterone levels seems to be increasingly important. However, urologists must be aware of the risk of side-effects of long-term hormone therapy and should adequately monitor their patients. (c) 2007 Published by Elsevier B.V. on behalf of European Association of Urology.