Prostate-specific antigen: Critical issues for the practicing physician

H. C. Ruckle, G. G. Klee, J. E. Oesterling

Research output: Contribution to journalArticle

39 Scopus citations


Background: Serum prostate-specific antigen (PSA), when used in combination with existing detection methods, improves the clinician's ability to detect early and potentially curable prostate cancer. Findings: This report describes clinically important issues about use of the serum PSA concentration for detecting early prostate cancer. Other PSA-related factors- PSA density, PSA velocity, and age-specific reference ranges-seem to enhance the ability of clinicians to distinguish benign prostatic conditions from early prostate cancer. Because digital rectal examination only minimally affects the serum PSA concentration, delaying a determination after this examination is unnecessary. Finasteride therapy for benign prostatic hyperplasia should be initiated only after the prostate has been evaluated for cancer because this 5α-reductase inhibitor lowers the serum PSA value by approximately 50%; however, reassessment of the prostate for cancer is necessary if the PSA level fails to decrease as expected or increases to more than 2 ng/mL during finasteride treatment. Conclusion: Currently, PSA is the most important, accurate, and clinically useful tumor marker for prostate cancer.

Original languageEnglish (US)
Pages (from-to)59-68
Number of pages10
JournalMayo Clinic Proceedings
Issue number1
StatePublished - 1994

ASJC Scopus subject areas

  • Medicine(all)

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    Ruckle, H. C., Klee, G. G., & Oesterling, J. E. (1994). Prostate-specific antigen: Critical issues for the practicing physician. Mayo Clinic Proceedings, 69(1), 59-68.