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What does increase in PSA levels with history of prostate cancer suggest?

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Oncologist, Surgical
Practicing since : 2003
Answered : 177 Questions
What does increase in PSA levels with history of prostate cancer suggest?
Posted Fri, 8 Aug 2014 in Cancer
Answered by Dr. Prashant Sharma 1 hour later
Brief Answer:
You need further testing.

Detailed Answer:
Hi Sir,

I have read your whole history.

It seems that your cancer prostate was cured with radiation many years back. Now PSA is rising again so we must consider it as a second primary, or there can be metastasis which were dormant previously and now they have activated giving rise to increase in PSA. Your physician did a repeat PSA after 1 month to confirm the rise in PSA, something called PSA-velocity.

An important thing I would like to say here, that we should have an absolute value of PSA, instead of >10. Because if it is 12, then we need to do more tests to find out the cause. If it is 100, then it is almost confirm that it is due to tumor and we will do imaging to find out the spread of tumor.

In my opinion a constant rise in PSA, with any value >25, along with weight loss and backache will indicate clinically towards disease and more tests should be done to rule out that. The battery of tests may include a pelvic MRI, MRI of spine, chest x-ray or others according to your condition.

Dear Sir, tablet bicalutamide if taken alone does't work properly. One has to block the production of testosterone, which can be done by surgery i.e. orchiedectomy, or by depot injections. You should start the drug only if it is a metastatic tumor. If the tumor is localized, then again radiotherapy may be given.

Hope u will be satisfied with this, or feel free to ask further.
At last I would like to say that XXXXXXX cancer society is a good organization. you should trust it. Whole world follows the cancer treatment guidelines of NCCN.
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