Chief Editor, Annual Report on Prostate Diseases, Harvard Medical School
Member of Harvard Health Publishing’s Editorial Advisory Board
Recognizing PSA’s Function in the Treatment of Prostate Cancer
Both healthy and malignant prostate cells produce the protein known as prostate-specific antigen, or PSA. Although PSA testing is commonly used to screen for prostate cancer, it is also essential for tracking the disease following diagnosis and therapy. PSA is actually regarded as one of the most useful instruments for monitoring the course of the disease and assessing the effectiveness of treatment for men with established prostate cancer.
PSA Following Diagnosis: An Important Monitoring Instrument
PSA testing is routinely performed after a prostate cancer diagnosis in order to:
· Keep an eye out for low-risk cancer in males who are on active surveillance.
• Find recurrence following radiation treatment or surgery.
• Evaluate how well metastatic illness therapies are working.
PSA Tracking After Surgery
PSA readings should drop to undetectable levels for men who have a radical prostatectomy, which is the surgical removal of the prostate. After surgery, any measurable PSA could be a sign of a biochemical recurrence, which would mean that cancer cells are still present in the body. Usually, this is the first indication that additional care or research may be required.
PSA Tracking After Radiation Therapy
Radiation therapy preserves the prostate gland, unlike surgery. PSA levels thus reach a nadir, the lowest value attained following treatment, rather than dropping to zero. This nadir should ideally be less than 0.5 ng/mL and less than 1.0 ng/mL.
A PSA increase of 2.0 ng/mL or more above the nadir is considered a biochemical recurrence following radiotherapy. Even if conventional imaging shows no spread, this increase suggests a possible return of the illness.
The Value of Kinetics in PSA
One important determinant of the necessity for additional intervention is PSA kinetics, or the pace at which PSA levels rise:
• Slow PSA doubling time (every few years): This might only need ongoing observation.
• Rapid PSA doubling time (every 6–8 months): Indicates a more severe illness and could lead to further examinations or medical interventions.
Imaging Developments: PSMA PET Scans
PSMA PET scans have become an effective diagnostic tool for males who have a biochemical recurrence but no visible metastases on conventional imaging. Doctors can find even tiny, otherwise undetectable metastases with these scans because they use a radiotracer that binds to prostate-specific membrane antigen (PSMA), which is present on prostate cancer cells. This invention makes it possible to detect the spread of disease earlier and with greater accuracy.
Tracking the Effect of Treatment for Metastatic Prostate Cancer
PSA levels are usually checked every three months in men with metastatic illness to assess the efficacy of treatment:
• A stable or declining PSA: Shows that treatment is effective.
• Elevated PSA: Could indicate treatment resistance.
With continued progress, some men might be able to stop treatment if imaging shows no active disease and PSA is undetectable.
PSA in Experimental Medicine
Additionally, PSA is used as a standard in experimental therapies and clinical trials. Researchers and clinicians can evaluate the efficacy of novel medications and treatment approaches by looking at a PSA reduction of 50% or more, which is typically seen as a favorable response to therapy.
In conclusion
In the treatment of prostate cancer, PSA testing is still a vital tool. PSA gives doctors vital information on how the illness behaves, from spotting early recurrence indicators to directing therapy choices in later stages. According to Dr. Marc B. Garnick, “one of the most crucial assessments that doctors and clinicians can carry out to ascertain the best treatments for men with prostate cancer is PSA monitoring.”
Disclaimer:
The main purpose of this article is to provide information. It should not be regarded as a replacement for expert medical guidance, diagnosis, or care. If you have any questions or concerns about your health, you should always speak with your healthcare professional.