Then you'll have repeat PSA tests once every 6 to 12 months for about 5 years. If your doctor says chances are high that your cancer will come back, you may need them once every 3 months. If your PSA levels stay normal, you can switch to once-a-year PSA tests. Ask your doctor how often you'll need a test.
Following a prostatectomy, the most widely accepted definition of a recurrence is a confirmed PSA level of 0.2 ng/mL or higher. After radiation therapy, the most widely accepted definition is a PSA that rises from the lowest level (nadir) by 2.0 ng/mL or more.
Undetectable PSA refers to the negligible amount of prostate-specific antigen in the blood that is less than 0.2 ng/mL. Preferably, test results are continuing to show undetectable PSA 5 years after radical prostatectomy. Once this margin is secured, the patient can be considered cured.
A test result above 0.2 ng/mL a few months after your procedure could be a sign that your prostate cancer has come back. This is called a biochemical recurrence. If your number is higher than it should be, it doesn't mean you definitely have cancer. Results can vary from person to person and from lab to lab.
Fortunately the five year survival rate for men with localized prostate cancer is nearly 100 percent. However, up to 40 percent of men will experience a recurrence, so it is important to understand your risk for recurrence.
Radical prostatectomy survival rates
The research showed that between 5 and 20 years after having the surgery, only 3% of the patients died of prostate cancer, 5% saw their cancer spread to other organs, and 6% had a localised recurrence.
Decoding a PSA Test
For men in their 40s and 50s: A PSA score greater than 2.5 ng/ml is considered abnormal. The median PSA for this age range is 0.6 to 0.7 ng/ml. For men in their 60s: A PSA score greater than 4.0 ng/ml is considered abnormal. The normal range is between 1.0 and 1.5 ng/ml.
The prostate can regenerate when androgen is restored.
However, approximately 35% of men will experience a detectable serum prostate-specific antigen (PSA) elevation within 10 years following surgery.
Physical activity like walking and riding a bicycle has been found to increase PSA levels. Because of this, men should avoid physical exercise, especially cycling for at least 24 hours before having a PSA level drawn.
Besides cancer, other conditions that can raise PSA levels include an enlarged prostate (also known as benign prostatic hyperplasia or BPH ) and an inflamed or infected prostate (prostatitis). Also, PSA levels normally increase with age.
Levels below 2.5 ng/mL are considered safe and those PSA levels over 4.0 ng/mL require further testing or monitoring. Conducting a PSA test when it is not necessary or called for may lead to over-diagnosis, according to the American Cancer Society.
0-2.5: Normal for a man 40-50 yrs. 2.5-3.5: Normal for a man 50-60 yrs. 3.5-4.5: Normal for a man 60-70 yrs. 4.5-5.5: Normal for a man 70-80 yrs.
The major possible side effects of radical prostatectomy are urinary incontinence (being unable to control urine) and erectile dysfunction (impotence; problems getting or keeping erections).
The 10-year PCSS was 98% for RP, 95% for EBRT and 98% for BT (log rank p < 0.0001). The 10-year overall survival was 87%. The 10-year event-free survival for those treated with RP was 79% and varied with Gleason grade: 87%, 74%, and 52% for Gleason 2–6, 7, and 8–10, respectively (p < 0.0001).
Prostate cancer can recur even many years after treatment, which is why it's important to keep regular doctor visits and report any new symptoms (such as bone pain or problems with urination).
It is possible for prostate cancer to return after a prostatectomy. One study from 2013 suggests that prostate cancer recurs in around 20–40 percent of men within 10 years of having a radical prostatectomy.
Even if your cancer was treated with an initial primary therapy (surgery or radiation), there is always a possibility that the cancer will reoccur. About 20 percent to-30 percent of men will relapse (have the cancer detected by a PSA blood test) after the five-year mark, following the initial therapy.
Hormone therapy is sometimes recommended for men who have a "biochemical" recurrence—a rise in prostate-specific antigen (PSA) level following primary local treatment with surgery or radiation—especially if the PSA level doubles in fewer than 3 months.
While no research has proven that stress or anxiety causes cancer to start, scientists have known for years that anxiety's lingering cascade of neurotransmitters, hormones and other biological molecules can lead to a rise in PSA and even inflame existing PCa.
There are currently no foods or beverages to avoid before taking a PSA test. While some foods might be linked to prostate conditions, no scientific evidence links the consumption of one food to elevated PSA levels. There is no need to avoid certain foods, coffee or alcohol before taking a PSA test.
The PSA level in the blood, like many lab tests, has a rhythm based on the time of the day i.e., a diurnal rhythm. Therefore, obtain your PSA blood tests in either the morning or the afternoon, but not both.