Prostate Cancer Expert Forum
increase in psa
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increase in psa

I was diagnosed prostate cancer in sept.2005 with Psa 44 and gleasen score was3+3=6. I was given Radiation 76Gy in 38 sittings and given  harmonal therapy Inj.Zoladex for 31 months. I stopped harmonal injection in June2008 and at that time my PSA was 0.03 which continues upto oct.2008 .Thereafter PSA was as under
                          PSA             testesterone
14/11/08              0.06                  45                    Whether increase in Psa is benign or the increase in PSa is due to
13/12/08              0.11                 150                    increase in my Testesterone level. Whether this is a residual Psa
19/01/09              0.19                  170                   which increases after demolition of harmonal injection effect.
19/03/08              0.22                   225                  Whether this is an indication of PSA relapse, What should I do
11/06/09              0.29                   320                   at this stage.
10/09/09              0.56                   401
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Thank you for your question. The ASTRO (American Society for Therapeutic Radiology and Oncology) criteria for biochemical failure (BF) after radiation therapy is three consecutive rises in the PSA after the post-treatment PSA nadir backdated to the midpoint between the nadir and the first rise. The Phoenix definition of BF is a PSA rise of 2.0 ng/mL after the nadir.

The Phoenix definition is widely accepted as a better criteria for defining BF. Having come off hormones it is natural for your PSA (and Testosterone) to rise.

Reaching the threshold of + 2 ng/mL it would be important to consider salvage therapy.

It is important to followup with your medical oncologist for an appropriate treatment plan.

Thank you for your question.


Ashutosh (Ash) Tewari, MD

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