Changes in PSA During Advanced Prostate Cancer

Medically Reviewed by Brunilda Nazario, MD on October 08, 2021

You probably had a blood test to check your levels of PSA -- a protein called prostate-specific antigen -- before your doctor told you that you have prostate cancer. You'll still get those tests now that your cancer has spread beyond your prostate.

The results are important, because if they show that your PSA level rises quickly, you may need different treatment.

Your prostate makes PSA. So do most prostate cancer cells. During prostate cancer treatment, changes in your PSA levels help show whether your treatment is working.

When you get treatment -- whether it's chemo, hormone therapy, a vaccine, or a combination -- your PSA levels should drop and stay low. If you have surgery to remove your prostate, you will likely have undetectable PSA levels after a couple of months. Sometimes, a very low level of PSA may be detected even after surgery. Talk to your doctor about what this might mean.

Checking Your PSA

Your doctor will closely track how quickly your PSA levels change over many months. They may call this your "PSA velocity." It can be a sign of how extensive and aggressive your cancer is.

PSA levels can be confusing. They can go up and down for no obvious reason. They can rise after treatment. And levels tend to be higher in older men and those with large prostates. Plus, the PSA blood test isn't precise. That's why doctors watch your results over time instead of focusing on one test result.

Your doctor will also consider other things, including what your PSA levels were before you had cancer, your overall health, and whether you've had radiation therapy. After radiation therapy it may take 1-2 years for your PSA to drop to its lowest level.

Each case is different, so ask your doctor about what your numbers mean. You'll want that perspective so you get the big picture of how you're doing.

Show Sources


Urology Care Foundation: "Prostate Cancer Testing," "Advanced Prostate Cancer."

The Prostate Cancer Charity: "Recurrent Prostate Cancer."

American Cancer Society: "Following PSA levels during and after treatment."

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