Introduction/Aim: Many factors can cause an increase of PSA
independently from the presence of prostate cancer . The
objective was to evaluate the fluctuation of the serum levels of
PSA during adjuvant intravesical chemotherapy or
immunotherapy. An increase of PSA due to intravesical BCG
and up to 3 months later has been reported (1). Patients and
Methods: Patients treated with intravesical chemotherapy or
immunotherapy for non- muscle invasive bladder cancer (NMIBC)
were entered in the study. Serum samples were collected
before starting intravesical therapy, during therapy (within 3rd
and 6th instillation) and 30 days after the end of the 6-week
induction regimen and during maintenance regimen when
given. Patients with urinary tract infections, history of chronic
prostatitis, elevated PSA before starting intravesical therapy,
palpable prostate nodule or prostate cancer were not included.
Results: Forty-five patients were studied, 34 receiving
chemotherapy and 11 BCG. Thirty-three patients completed the
induction regimen and in 12 more patients the research is
ongoing. Out of the 33 evaluable patients, 23 received
chemotherapy (mitomycin or epirubicin), while 10
immunotherapy (BCG Connaught). The pre-induction PSA
mean level was 2.9 ng/ml.We observed a median PSA increase
of 33,5% (p<0.0001) during therapy, in 18 (54.5%) patients. Twelve patients (36.3%) showed a median PSA decrease of
31.4% (p=0.3638). In two patients only (6%) PSA remained
unchanged.We also observed a median increase of serum PSA
levels of 87.4% at one month after the end of induction
regimen. No significant difference between serum PSA level
fluctuations induced by chemotherapy or BCG was detected:
median increases during therapy and 30 days after the end were
91.7% and 149, 7% and 91.7% and 133% respectively
(p<0.001). Discussion and Conclusion: Our preliminary study
shows a clinically relevant increase of serum PSA levels in men
undergoing both adjuvant intravesical BCG or chemotherapy.
We confirm the results of the few studies reporting the increase
of PSA during intravesical therapy with BCG or chemotherapy
(2). The above mentioned variations should be considered
when selecting patients undergoing prostate biopsy