PSA helps medical providers screen for and diagnose prostate cancer at an early stage.
But there’s more to the test than just that.
What is PSA?
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PSA stands forprostate-specific antigen.
It’s a protein produced by cells in the prostate gland.
The PSA test measures levels of this protein in the blood.
High levels can be a sign of prostate cancer.
Why PSA Is Important
PSA plays many different roles.
The most common is determining prostate cancer risk.
PSA is also used to help determine the stage of a newly diagnosed prostate cancer.
Staging is a measurement of how advanced the disease is.
The PSA doubling time can also detect a relapse of cancer after treatment with surgery or radiation.
Detecting a Relapse
PSA is useful for detecting a relapse of prostate cancer after surgery or radiation.
After prostate cancer surgery, PSA is normally undetectable, and even small rises could point to a recurrence.
After curative radiation, the PSA generally stays under 1.0 long-term.
However, there are exceptions.
Sometimes, the PSA level drops slowly after radiation and it may take years to reach its lowest point.
Younger people may have a short-term PSA rise that’s not cancer-related.
That’s more common after the seed-implant pop in of radiation.
This temporary rise is called a “PSA bump” or “bounce.”
It can develop between one and four years after treatment.
It may be linked with anti-cancer activity in the immune system, which is a good thing.
PSADT
The PSA doubling time has a big influence on treatment.
Risk categories:
The higher the risk, the more aggressive the treatment.
If you were originally in the high-risk category, treatment may mean Lupron Depot plus pelvic lymph node radiation.
After surgery or radiation, medical providers watch for a cancer relapse with PSA and PSADT test results.
Common scans are:
Cancer in the prostate or prostate bed is considered a local recurrence.
Cancer that’s spread outside of that area is called metastatic.
Treatment of metastatic recurrence depends on where it is and many other factors.
With a local relapse, disease suppression with Lupron Depot is an option.
Be sure to check on your coverage before you opt for one of these expensive tests.
Your medical provider may suggest adding more powerful drugs like Zytiga, Xtandi, or Taxotere.
Newer scans help the cryosurgeon focus on cancerous areas, rather than treating the whole prostate.
This is called focal cryotherapy.
It offers much fewer side effects than freezing or removing the whole gland.
Another alternative is prompt treatment with Lupron Depot.
This can suppress the local disease.
Lupron Depot alone is less likely to work.
The prostate is rarely removed after radiation, due to high rates ofincontinenceanderectile dysfunction.
Treatment courses depend largely on whether your original cancer was treated with surgery or radiation.
Summary
Deciding on a treatment for aPSA relapseis complex.
The choice is based on factors including your original risk category, PSA doubling time, and scan findings.
The location of recurrent cancer may remain uncertain, even with the best scans.
Most people with prostate cancer have a good 15-year prognosis.
Sometimes, prostate cancer can be cured.
Even when it’s not, it can be controlled for years and even decades.
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