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Questions posted in the
The Urology Forum have been answered by urologists from Henry Ford Health System and by Dr. Kevin Pho.
Question Title: PSA readings following total prostatectomyForum: The Urology Forum
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A collegue had a total prostatectomy 8 months ago. His first follow up showed a psa <0.2. He has just had a further follow up and his psa is now 0.8. Is this increase likely to indicate that the CA is still present or had spread prior to surgery? I have read that resent research has suggested that psa is not prostate specific and is secreated by other cells. Could this be an explaination for the raise? or is it more likely that the disease was not erradicated? Comments and thoughts would be very welcome - thanks
Dear Mike, Thanks for your question. PSA is prostate specific. Prostate cancer and the benign prostate make PSA. Occasionally there are low level elevations thought to be due to urethral glands but usually these values drop back down to undetectable levels. If there is not a lab error and the entire prostate was removed ( as assumed with a previous PSA of < 0.2), then the prostate cancer has spread. This probably occurred prior to surgery and was too small to be detected by the PSA test until now. A bone scan or Prostascint scan (a nuclear antibody test for PSA producing cells) may locate the site of metastasis. If it is still in the pelvis, (positive surgical margins on the prostatectomy pathology report or in the local lymph nodes) radiation maybe offered. If not hormonal blockade therapy is usually recommended although it can be used for local disease also. More individualized care is available at the Henry Ford Hospital and its suburban campuses by calling (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians’ notes and lab test results that you may be able to obtain. These will help us greatly. This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
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