8 April 2020: An anxious day waiting for my PSA (Prostate Specific Antigen) blood test results. To get an accurate reading one has to wait six weeks after surgery. I’ve learned that PSA is very reliable for measuring prostate cancer recurrence risk after treatment. However it is not reliable enough as your sole diagnostic tool – see prostate cancer screening post.
In the sober words of the American Urological Association in the journal Oncology:
“A detectable PSA following radical prostatectomy is associated with eventual disease recurrence in most patients. The median interval from PSA recurrence to cancer death is between 5 and 12 years, depending upon the cancer’s Gleason score.”
Fears and risks of cancer recurrence
It’s been hard waiting six weeks to hear whether my cancer is still active. My surgeon showed me graphs indicating how some patients still have non-zero PSA after surgery, or sometimes it goes right down but later starts to rise. I don’t want that.
With my prostate removed, PSA should be so close to zero as to be undetectable. If there is still detectable prostate specific antigen (PSA) in my blood six weeks after surgery, it means the cancer is still active somewhere in my body.
What happens if PSA starts to rise again? Further treatment options
If I get the dreaded non-zero result, I am aware that further action will be needed. This might include radiation therapy or hormone blocking therapy – both very unattractive to me. When I lay awake at night, I hope mine will be OK. And (tentatively at least) resolve to use natural methods to combat rising PSA if it happens.
Lucky to get good news
At last I get the call with my doctor. There is no in person consultation due to coronavirus lockdown. He brings good news. My PSA test result is less than 0.02 ng/ml – the much hoped-for undetectable PSA. Yay! No guarantee, and I have to keep testing regularly. And it is an excellent sign for which I am deeply grateful.
[Editor’s note: read this guest post on what happened to a man whose PSA kept rising after surgery]