Using prostate-specific antigen to eliminate the staging radionuclide bone scan

The staging evaluation of the patient with prostate cancer traditionally has included a radionuclide bone scan. There is clear evidence to allow elimination of the radionuclide bone scan in the asymptomatic patient with newly diagnosed prostate cancer with a serum prostate-specific antigen level of 10 ng/mL or less. In addition, there is preliminary evidence to support elimination of the radionuclide bone scan in the staging assessment of the asymptomatic prostate cancer patient with a detectable, increasing serum prostate-specific antigen level that is 2 ng/mL or less after radical prostatectomy. Practice of these guidelines results in tremendous economic savings.