Carcinoma of the Prostate: The Clinical Potential of Biological Markers Other Than Acid Phosphatase
Carcinoma of the prostate is a slowly progressive disease which may be managed in many different ways. Treatment alternatives include no treatment, surgery, irradiation, endocrine therapy and cytotoxic chemotherapy. Diagnosis is easily achieved by rectal examination and biopsy, and scanning techniques are readily available for accurate clinical staging. The common osteosclerotic metastases are not, however, easily assessed for progression or regression and other marker lesions suitable for accurate measurement do not often occur, even in advanced progressive disease. Therefore a good biological tumour marker would be invaluable to aid the clinician monitor disease progression and the response to treatment and to assess new hormonal and chemotherapeutic regimes in phase II clinical trials. Although Huggins and Hodges (1) used plasma acid phosphatase as a marker for this tumour it has the disadvantage that it is rarely elevated in non-metastatic cancer and that in metastatic disease its sensitivity (percentage true positive elevations) as a marker is low. In addition during hormonal therapy disease progression is often not accompanied by rising plasma levels of this enzyme.
KeywordsProstatic Cancer Benign Prostatic Hyperplasia Bone Alkaline Phosphatase Creatinine Kinase Alkaline Phosphatase Isoenzyme
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