Following PSA Levels During and After Prostate Cancer Treatment

  • 4 years ago
https://www.cancer.org/cancer/prostate-cancer/treating/psa-levels-after-treatment.html

Following PSA Levels During and After Prostate Cancer Treatment

A man’s prostate-specific antigen (PSA) blood level is often a good indicator of how effective treatment is or has been. Generally speaking, your PSA level should get very low after treatment. But PSA results aren’t always reliable, and sometimes doctors aren’t sure what they mean.

Before starting treatment, you might want to ask your doctor what he or she expects your PSA level to be during and after treatment, and what levels might cause concern. It’s important to know that the PSA level is only one part of the overall picture. Other factors can also play a role in determining if cancer is still there, if it is growing, or if it has come back.

It’s also important to know that PSA levels can sometimes fluctuate a bit on their own, even during or after treatment, so they may not always be a sign of what is actually happening with your cancer. Understandably, many men being treated for prostate cancer are very concerned about even very small changes in their PSA levels. The PSA level is an important tool to monitor the cancer, but not every rise in PSA means that the cancer is growing and requires treatment right away. To help limit unnecessary anxiety, be sure you understand what change in your PSA level might concern your doctor.

During watchful waiting (observation) or active surveillance
If you choose observation or active surveillance, your PSA level will be monitored closely (most likely along with other tests) to help decide if the cancer is growing and if treatment should be considered.

After surgery
Your PSA should fall to a very low or even undetectable level within a couple of months after radical prostatectomy. Because some PSA can remain in the blood for several weeks after surgery, even if all of the prostate cells were removed, doctors often advise waiting at least 6 to 8 weeks after surgery before checking the PSA level.

Some men might worry if their PSA is still detectable even at a very low level after surgery, but this does not always mean cancer is still in the body. Modern PSA blood tests can detect even tiny amounts of PSA, but these amounts might not always be significant, especially if they are not rising over time. It could just mean that you have some cells in the body making PSA, but these aren’t necessarily cancer cells.

Still, having any detectable PSA after surgery can be stressful for men and their families. If your PSA is still detectable after surgery, even at a very low level, talk to your doctor about what it might mean, and what he or she thinks is the best course of action. Some doctors advise following such low PSA levels over time to get a better idea of what’s going on. Other doctors might recommend further treatment.

After radiation therapy
Radiation therapy doesn’t kill all of the cells in the prostate gland, so it's not expected to cause the PSA t