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According to Isaac Asimov, “The saddest aspect of life right now is that science gathers knowledge faster than society gathers wisdom.”

August 5, 2022

Promising treatment if PSA increases after prostatectomy

Researchers have identified a viable new treatment option for individuals whose PSA levels rise after radical prostatectomy.

Promising treatment if PSA increases after prostatectomy

Numerous men who undergo radical prostatectomy for prostate cancer live their entire lives without a recurrence of the disease. Twenty to forty per cent of them will suffer an increase in prostate-specific antigen (PSA) values within ten years of surgery. If the prostate has been removed, PSA levels in the blood should be undetectable, indicating that cancer may have returned. This is known as a biochemical relapse, and it is often treated with radiation to the prostate bed, where the prostate resided prior to its removal. This type of treatment, known as pelvic bed radiation therapy or PBRT, is frequently successful in reducing PSA levels to zero for years.

Now, a comprehensive study demonstrates that PBRT is even more beneficial when paired with other therapies. Men who experience a biochemical recurrence following radical prostatectomy may benefit from these findings.

Funded by the National Cancer Institute, almost 300 medical centres in the United States, Canada, and Israel participated in the SPPORT phase 3 clinical trial. Between 2008 and 2015, a total of 1,797 men with post-surgical PSA values between 1 and 2 nanograms per millilitre (ng/mL) were included.


Approximately equal numbers of patients were assigned at random to each of the three groups. Group 1 received PBRT alone, while group 2 received PBRT combined with four to six months of androgen deprivation therapy (ADT). (Also known as hormonal therapy, ADT inhibits testosterone, a hormone or androgen that promotes the development of prostate cancers.) The men in group 3 were treated with PBRT, ADT, and radiation to the pelvic lymph nodes, where prostate cancer generally spreads first. The researchers intended to determine which of these three treatments is the most successful at preventing the advancement of the disease.

The outcomes, side effects, and next steps


According to their findings, more intensive treatments produced greater results. After five years, slightly more than 70 per cent of men in group 1 were still disease-free, compared to 80.3% of men in group 2 and 87.4% of men in group 3. During the follow-up period, 145 men in group 1 acquired further PSA elevations, compared to 104 men in group 2 and 83 men in group 3. Similar tendencies were identified in terms of the number of men who acquired metastases or cancer that develops resistance to hormone therapy as it spreads.

Additionally, the more rigorous treatments produced more short-term side effects, including diarrhoea. After three months, however, disparities in adverse effects between the three groups disappeared.

The authors underlined that a longer follow-up is still necessary to determine whether the addition of ADT and pelvic node radiation to PBRT actually increases survival. In addition, the study did not analyse a more recent therapeutic strategy for biochemical relapse, in which physicians employ advanced imaging techniques to locate extremely small metastases throughout the body, which are then treated directly with radiation.

Dr Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor of the Harvard Health Publishing Annual Report on Prostate Diseases believes it is essential for men to understand that any detectable PSA level after radical prostatectomy is abnormal and warrants further evaluation. "The traditional normal PSA range of 0 to 4 ng/mL does not apply to males whose prostates have been surgically removed," he explains. "Significant evidence of further benefits from combining ADT and pelvic radiation was found during this research. To determine whether this represents a new standard of care for biochemical relapse, additional research is required."
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“He Asked For Wisdom” Monday, June 16, 2025

Key Verse “Give me now wisdom and knowledge, that I may go out and come in before this people: for who can judge this thy people, that is so great?” (2 Chronicles 1:10) Text —2 Chronicles 1:1-10 Message William Shakespeare says, “The fool doth think he is wise, but the wise man knows himself to be a fool.” When God gave Solomon the opportunity as “king over a people like the dust of the earth in multitude” (verse 9) to ask what He would give him, Solomon knew he needed wisdom to reign in David his father’s stead. So, instead of asking for riches, power, and other mundane things of this life like the people of the world would do, he asked for wisdom. The Scripture admonishes young people saying, “Trust in the LORD with all thine heart; and lean not unto thine own understanding. In all thy ways acknowledge him, and he shall direct thy paths. Be not wise in thine own eyes: fear the LORD, and depart from evil” (Proverbs 3:5-7). We all know the sinking feeling we have when we do something poorly. Lack of wisdom brings disgrace and pain but wisdom in trials makes us useful to God and to fellow men. Only wise young people strive to serve God well and have great influence for greater good. Quote Lack of wisdom brings disgrace Challenge Allow God to direct your paths. Prayer for today Dear God, grant me more wisdom, in Jesus’ name.
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