How do you know if you’re cancer free? What level PSA should you have in order to be cured? Dr. Tutrone discusses the different types of prostate cancer treatment and what the PSA expectations are for each type of treatment in order to be considered cured, as well as how long cancer monitoring must be done after prostate cancer treatment. Learn more in the video.
Dr. Ronald Tutrone: So how I know if I am cured of prostate cancer once I received treatment and what is a good PSA level after treatment. Well if you have had a radical prostatectomy, your PSA should be undetectable in order to deem yourself cured of the cancer and that is sort of the beauty of having surgery and that if you do not have any prostate tissue remaining in your body, your PSA level should be undetectable. If it is undetectable, then you are cured. So that’s why we follow patients after having radical prostatectomy with frequent PSAs often in the first year, we will delay every three to six months and then after two years, we will check it annually. It should be checked at least up to 10 years because there are cases where it can recur up to 8 to 10 or even 12 years after you have had a prostatectomy. So it is important that you have it checked annually and earlier after surgery, get it checked more frequently. If there is detectable PSA following prostatectomy that likely means you have recurrent cancer and those treatment options you should discuss with your urologist on how to deal with it at that point. You will need scans such as CAT scans and bone scans in order to try to detect where the cancer is, but this can often be difficult to do. Following radiation, it is a little trickier because prostate has not been removed so you don’t usually get an undetectable PSA. The current guidelines used by the radiation oncologist is having a PSA of under 1 is considered a cure. The difficulty becomes in subsequent years after having undergone radiation if your PSA starts rising say from 0.6 to 0.8 to 1 to 1.2 and at that time, if it is rising rapid enough, we will recommend you undergo a prostate biopsy to determine if there is any residual cancer within the prostate. So the answer is, if you have had a radical prostatectomy, your PSA should be undetectable and if you have had radiation whether that’s brachytherapy or seed implant or external beam radiation therapy, your PSA should be below 1.
Dr. Tutrone is the Medical Director of Chesapeake Urology Research Associates (CURA) and Chief of Urology at the Greater Baltimore Medical Center. He has been voted a “Top Doc” by Baltimore Magazine three times, and has authored numerous articles in the urology literature.
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