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PSA before treatment vs. after treatment.

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Prostate Cancer
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Posted 1/31/2013 7:55 PM (GMT 0)
Another question from me. I'm sure I'll have many more over the next 49 days.

Anywho,
PSA testing and the insignificant/unpredictable/unreliable results as seen by the recommending medical authorities.

If this test offers no cohesive, reliable way to indicate cancer before treatment, then why is there such a total faith on the PSA test after a treatment?, whether that be surgery, radiation or hormone.

It seems that all the doctors, institutions, insurance and government authorities are at odds with each other over this pre diagnoses test, yet, it is almost totally relied on after a cancer treatment to indicate that you're cured, no matter what that treatment may be.
It seems contradictory.

I'm for PSA testing, I believe 100% that my cancer started or was detectable in 2007 (most likely earlier than that, as I have no baseline test that shows .01) my first PSA test showed 2.8.

An untrust before DX, and total trust after treatment. Just seems confused

I'm clearly not thinking clearly...
Posted 1/31/2013 8:09 PM (GMT 0)
iSpark,
After surgery when PSA drops out to undetectable it becomes more of a surrogate for disease progression. Not so much with other types of therapy, at least in the short term. PSA is detectable when a prostate is present and it is not a cancer specific measurement. In other words if you have a prostate still then PSA will be present. How much so is the controversy.

tony
Posted 1/31/2013 8:12 PM (GMT 0)
Makes complete sense to me.

The protein released into your blood is unique to the prostate (that's why they call it prostate SPECIFIC antigen).  Prostate cancer also produces the same antigen, but (of course) prostate cancer originates in the prostate...even if it later spreads elsewhere.

So the PSA is unique to the prostate, but prostate cancer, or a prostate infection, or other prostate disease(BPH) all can contribute that same protein into your blood.  Destroy or remove the prostate, and no more prostate infections or other prostate diseases...what's left is (essentially) only prostate cancer (small levels of PSA from the remaining prostate are the exception for those who don't have surgery).

Does that help clarify?

Posted 1/31/2013 8:21 PM (GMT 0)
Men age 40-50 typically have PSA between 1.0 and 2.0. So I doubt that you would have had undetectable PSA before.
After the prostate is removed , it can not produce PSA. Only cancer cells would produce PSA. So tracking PSA after surgery would reflect the number of prostate cancer cells in the body. A steady increase would reflect an increase in prostate cancer.
Good luck with the treatment.
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