What to do for XXXX @entity1 with a rising PSA?--A survey of Australian practice.

@entity1 @entity263 @entity4557 @entity342 @entity1486
PURPOSE: To document current Australian management of asymptomatic @entity263 @entity1 with @entity1486 (PSA) relapse after radical treatment or considered unsuitable for radical treatment. MATERIALS AND METHODS: Four case scenarios-postprostatectomy PSA @entity4557 ( @entity4557 ) with a slow or a rapidly rising PSA level, or no radical treatment-were presented. Management preferences, including (where relevant) @entity4557 , @entity342 ablation either immediate or delayed until a PSA rise or symptomatic progression, and other approaches, were identified. The preferred methods of @entity342 ablation were noted. RESULTS: One hundred eighteen informative replies out of 324 e-mailed surveys were received. For postprostatectomy PSA relapse, 59% of respondents favored salvage @entity4557 . For post- @entity4557 with a slow or a rapidly rising PSA level and treatment of nonradical @entity1 , there was no clear consensus of opinion, with respondents divided among the different options. A diverse range of PSA levels was cited for delayed intervention, with values ranging from 0.8 to 100 ng/mL. PSA doubling time proved a more consistent criterion for determining intervention. Most respondents favored the use of a luteinizing hormone-releasing hormone agonist as first-line @entity342 ablation, although @entity1 choice was recognized as important in all decision making. CONCLUSIONS: A lack of available evidence underlies the diversity of opinion regarding the management of asymptomatic @entity263 @entity1 with a rising PSA. The need for randomized controlled trials in this area is highlighted.
