Biochemical Failure

Last Modified: February 20, 2009


Dear OncoLink "Ask The Experts,"

What does biochemical failure mean?


Richard Whittington, MD, Associate Professor of Radiation Oncology at the University of Pennsylvania School of Medicine, responds:

Biochemical failure is the return of a previously treated prostate cancer, which is determined by a rising PSA (prostate specific antigen). This differs from clinical failure, which is detected by a radiology scan (such as CAT scan or bone scan) or tissue biopsy.

There is no standard definition of biochemical failure. Some people say biochemical failure is defined as 3 consecutive rises in PSA, while others say it is defined as 2.0 ng above the lowest post-treatment measurement. Still some others will qualify their answer by saying 3 rises with a minimum total rise of 1.0ng/ml. Even after radical prostatectomy, and knowing that the only thing in the body that makes PSA is the normal prostate gland or prostate cancer, some people still say that a PSA of 0.1 is a recurrence, while others use 0.2 or 0.4 (2 rises above “undetectable”).


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