New molecular biomarkers for the prognosis and management of prostate cancer--the post PSA era.

The widespread use of the PSA test has led to increased detection of the disease at earlier stages and a reduction in the number of patients where metastatic disease is found at diagnosis. However, there are significant limitations to the PSA test such as its lack of specificity, elevation in benign disease and failure to detect a significant number of PSA-negative tumours. Therefore, PSA is now commonly regarded as an indicator of prostate volume and is not independently diagnostic or prognostic in prostate cancer. Due to these limitations, there is an urgent need for new prognostic biomarkers to enhance the clinical management of prostate cancer. There have been many recent advances in high-throughput technologies for measuring gene and protein expression in minimally invasive samples (e.g. blood, urine) that could more accurately predict disease progression. This review article gives a brief overview of biomarkers that are currently showing prognostic potential in prostate cancer research.