This article was translated from the original Portuguese. Português
Why can PSA rise after the prostate has been removed?
After prostate removal, men are followed up after surgery with PSA tests every 3 to 4 months.
PSA may rise because there may have been metastatic foci before the prostate was removed. These metastases are clusters of cancer cells that remain dormant in normal tissues (such as the lymph nodes).
These cells may remain dormant for years (four, five, six years) and, for reasons doctors cannot yet explain, at some point they may “reactivate” and start producing PSA, giving rise to a new focus of prostate cancer.
In short: PSA may rise because metastases may already exist from the outset, even in very early cases, although this risk is small.
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Book via WhatsApp Prostate cancer guidePSA may also rise due to a phenomenon that specialists call a “false positive”, because the blood test uses an antibody that reacts with the PSA protein in the blood.
The point is that, although this antibody is highly specific for the PSA molecule, it can cross-react with other similar proteins, altering the test result. Because specialists are aware of this, in men who no longer have a prostate PSA is considered “normal”, as test “noise”, up to a value of 0.2. From that value onward, PSA is considered abnormal and a search begins to determine whether there is any focus of active disease in the body.
In other words, there are two reasons why PSA can rise after prostate removal.
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Book via WhatsApp Prostate cancer guide
Dr. Bruno Benigno
Urologist and uro-oncologic surgeon (CRM-SP 126.265 · RQE 60022). More than 1,500 robotic surgeries. Member of the AUA, EAU and SBU. Meet Dr. Bruno · In the Media
This content is educational and does not replace a medical consultation. Each case must be assessed individually, based on AUA, EAU and NCCN guidelines.
