Is PSA Still the Best Marker in Diagnosis and Monitoring of Prostate Cancer?

Prostate cancer is the second most common cancer in males. At an early stage, prostate cancer barely causes any symptoms. The presence of symptoms upon presentation usually implies the presence of locally-advanced or metastatic disease. Therefore, early detection of prostate cancer is a necessity. Serum Prostate-Specific Antigen (PSA) test and Digital Rectal Examination (DRE) are used for early detection by the urologist. However serum PSA level is not only affected by the tumours but also other factors. The limitations of serum PSA test led to the introduction and application of various PSA derivatives to improve test sensitivity and specificity. In this review article, we provide a literature review and analysis of the currently available PSA test and its derivatives compared to new and developing potential tumour markers for detection and monitoring of prostate cancer.