PSA-detected (clinical stage T1c or B0) prostate cancer: Pathologically significant tumors

With the rapidly spreading enthusiasm for early detection of prostate cancer and the increasing use of serum PSA to evaluate the gland, more cancers that are not palpable on digital rectal examination are being identified. These tumors have pathologic characteristics that are very similar to those of clinically localized, palpable prostate cancers identified on digital rectal examination. Thus, the tumors detected on the basis of an elevated serum PSA value should not be disregarded as insignificant. In fact, these tumors should be given the same therapeutic consideration as the clinically localized, palpable cancers. In the TNM staging system, 'PSA-detected' cancers can be classified as stage T1c, and in the Whitmore-Jewett staging system, they can be referred to as stage B0. Long term follow-up of these prostate cancers will be necessary to establish the prognosis.