Tracking Your PSA Levels
You probably already know that tracking your PSA levels is an important process in the early detection and diagnosis of your cancer. What you may not know is that tracking these levels is an important aspect in monitoring how well your cancer treatment is working.
Tracking PSA levels can be a complicated and anxiety-inducing process. We can help.
By understand how and why your doctor uses the PSA test to monitor your cancer, you can choose the most effective course of treatment and eliminate any unnecessary fear and stress.
The PSA Test: An Overview
The prostate-specific antigen – or, PSA – test is typically used as an indicator of the efficacy of your prostate cancer treatment. Prostate specific antigens are proteins secreted by the prostate gland.
Antigens are toxins that induce the production of antibodies in your immune system. The prostate specific antigen test is designed to measure the possibility of cancer: the higher the PSA levels, the higher the production of toxins in your body and the greater chance that you have cancer.
Your PSA levels become some of the most important numbers in your struggle with prostate cancer.
Fluctuations in PSA levels are typical in men, particularly as they age. Medications and health conditions are also factors that contribute to the rise of prostate specific antigens in the blood stream.
Low levels of PSAs are normal in males, and are typically measured in nanograms, about 4 ng/mL is normal; however, according to the American Cancer Society, cancerous tissues emit more than ten times the prostate specific antigen levels than noncancerous tissues, and any reading above 10 ng/mL could be cause for concern.
What your PSA levels tell you during treatment
The American Urological Association recommends that healthy males over the age of 40 should undergo screenings for prostate cancer, including the PSA test.
Before considering any type of treatment, you should speak with your doctor about what your PSA levels mean and which treatment options are right for you.
Depending on the type of treatment you undergo, your PSA levels will play an important role in monitoring the growth and treatment response patterns of your cancer.
While PSAs are an important tool in monitoring your cancer and treatments, the test is merely one small aspect of your cancer treatment. In order to fully understand what your levels mean, you should speak to your doctor what you can expect before, during, and after treatment and what levels are cause for concern.
Active Surveillance and PSA Levels
If you and your doctor decide that active surveillance is your best course of treatment, you will undergo frequent PSA tests to monitor your levels.
Active surveillance is typically used for men with low-grade, slow-growing cancers.This type of treatment uses PSA levels, digital rectal exams, and biopsies to monitor the growth rate of the cancer.
While fluctuation in PSA levels are natural, a rapid rise in levels during active surveillance treatment could be cause for concern. In the case of active surveillance, your doctor will not so much be concerned with the number associated with your PSA levels, but the pattern and rate of their change.
If your levels change quickly and drastically, it could indicate that your cancer has metastasized and that another course of treatment will be necessary.
Radiation Therapy and PSA Levels
Radiation therapy impacts PSA levels differently from other forms of treatment. Radiation typically does not eliminate all of the cancerous cells in the prostate, which means that your PSA levels might not noticeably drop.
In some cases, such as with brachytherapy, your levels may spike post-surgery.
However, most men find that their levels drop gradually, within a few months or years of treatment. Your doctor will schedule follow-ups to monitor these levels closely after radiation therapy to assure that the radiation has targeted most of the cancerous cells.
With this type of therapy, a PSA rise over 2 ng/mL could indicate that the radiation has not worked.
Radical Prostatectomy Surgery and PSA Levels
Because radical prostatectomy surgery involves the complete removal of the prostate gland – where PSA is concentrated – you can expect your PSA levels to drop drastically post-treatment. In most instances, they will be virtually undetectable after prostate removal.
Despite the efficacy of radical prostatectomy surgery, most doctors will recommend waiting for 6-8 weeks after prostatectomy surgery prior to having your PSA levels checked. This will ensure a more accurate monitoring of your PSA levels and assessment of the treatment.
Your Post-treatment PSA Monitoring
It is important to follow your treatment recovery regimen as closely as you can, which will include regular check-ups and PSA tests.
It is easy to get hung up on your PSA levels as the sole indicators of how well your cancer is responding, but there are a few reasons why you may not need to be worried about high PSA levels.
False positives – or detection of the presence of cancer where there is none – can increase with age, as PSA levels fluctuate. Additionally, ethnicity, prostate volume, medications or the presence of infection can all contribute to a spike in PSA levels.
These false positives made the test an unreliable prognosis tool for years, causing unnecessary biopsies, depression, and anxiety in patients.
However, new ways of reading the PSA tests are making them more reliable, particularly the Complexed PSA – or cPSA – test, which monitors the bonds between antigens and specific proteins associated with cancer in the blood stream.
Additionally, these tests have increased in sensitivity over the years, and can now detect even the smallest amount of prostate specific antigen presence in your bloodstream, which makes it important to understand how the test is used.
The patterns established by prostate specific antigen tests, rather than specific PSA levels in your blood stream, are what doctors look at when assessing your cancer’s response to treatment.
When combined with digital rectal exams and, if necessary, regular biopsies, the PSA test becomes on part of an effective trio that can accurately monitor how well your cancer has responded to treatment or it’s rate of progression.
Your PSA levels do not define you or your cancer. They cannot predict a man’s cancer symptoms or his life span.
Every man’s struggle with prostate cancer is different and, therefore, the PSA test will play a different role in each cancer patient.
Understanding how and why the PSA test is used can help ease anxiety, fear, and stress.
While we pride ourselves on providing reliable resources to help you understand your prostate cancer, you should discuss your PSA – and what it means – with your doctor.