Sometimes after finishing prostate cancer treatment, men get an unwelcome surprise: their prostate-specific antigen (PSA) levels creep higher, suggesting tumors too small to be seen lurk somewhere in the body. This leads to several options. Doctors can continue to monitor a man’s condition with imaging scans. Or, given the anxiety associated with rising PSA, they might try to lower the levels with chemically “castrating” drugs that inhibit testosterone, a hormone that makes prostate tumors grow faster. Following that treatment, called androgen deprivation therapy (ADT), PSA generally declines and may become undetectable. But what if PSA climbs further despite ADT’s inhibiting effects on testosterone? This condition is called nonmetastatic, castration-resistant prostate cancer (nmCRPC). It’s called “nonmetastatic” because cancer hasn’t spread in a way that’s detectable with
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