Declining PSA

I've read many reports here and elsewhere that after surgery/seed/EBRT etc. PSA levels drop.

And if declining PSA levels indicate reduction in prostate cancer, then the drop is definitely good news!

But I've often wondered ... does declining PSA actually *mean* that prostate cancer is disappearing? or just that it's likely that it's disappearing?

I realize PSA is used to indicate a prostate problem. And that PSA levels can vary even if there is no prostate cancer. (sexual activity, bacterial infection, inflammation, etc.)

So are we just relying on declining PSA levels to show we're "cured"?

Thanks.
Tom in CT

Rule #1 in PCa....exceptions, contradictions exist all over the place...thus NO RULES! (to some degree)   Generality...yes monitoring Psa values is a good clue in the biology of PCa, and thus we all use it. Exceptions exist in aggressive PCa or changed into aggressive PCa, whereby Psa values are not given off and yet the disease is progressing and sometimes even shows up on scans with little or no Psa value to correlated such a huge change.

I can give you examples on both sides of this discussion. This is why the leading oncologists know most about PCa's on additional monitoring testings that should be ongoing in patients. Like in Dr. Strum's book page 35 is one example of a panel of tests he suggests, probably just a guess, but with his 40 years of experience in seeing all types of cases in PCa (-: ). There is alot more to PCa, than just PSA numbers....although as patients we look plenty at those.
This also explains why A.S./W.W. needs close monitoring, besides just PSA, the wiser docs realize such and have additional criteria...like Dr. Bahn, Scholz, Lam...et al. My onco type doc does a decent number of those additional testings...glad he isn't as dumb as my past uro-doc...whom was wealthy as heck and likely praising himself as a total success measured in dollars and collected cash cows, only I strayed away back in 2004/5.

Post Edited (zufus) : 4/26/2011 8:15:43 AM (GMT-6)