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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.
Some prostate cancers are high risk, aggressive, and more likely to spread. Others are low
risk, least likely to have bad outcomes. The biopsy says cancer, but correct diagnostic
tools provide limited information about how aggressive a man's individual disease is,
so most men decide to treat prostate cancer immediately. Once treated, many men experience
serious long term side effects, like incontinence and *** impotence. Immediate treatment
is not always needed, but right now a man cannot be sure if his cancer is the kind that
is likely to require treatment or if he is okay to wait for now. What if there was a
test that could determine how aggressive prostate cancer is? Genomic Health is developing a
new test to do just that. By reviewing the underlying biology of the tumor and using
genes for multiple biologic pathways, the test can predict the aggressiveness of prostate
cancer when diagnosed, allowing a man to make a more informed treatment decision with confidence,
taking care of himself with more information, and greater peace of mind.