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General Medical Questions
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Question : I was treated with radiation therapy approximately 1 year ago for prostate cancer. My PSA after treatment was not detectable. I get a PSA every 3 months. My last PSA was 1.2. Does this mean the prostate cancer is still active? What are my options?
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The Trusted Source
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Howard LeWine, M.D.

Howard LeWine, M.D., is chief editor of Internet Publishing, Harvard Health Publications. He is a clinical instructor of medicine at Harvard Medical School and Brigham and Women's Hospital. Dr. LeWine has been a primary care internist and teacher of internal medicine since 1978.

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May 04, 2012
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A:

Before suggesting that the prostate cancer has returned, I would want to see another PSA about 3 months after the last one. If it is continuing to rise, the cancer has likely become more active.

Your options are based on several factors, including:

  • What is the rate of rise of PSA? If it is going up very slowly, then you have time before rushing to more treatment.
  • What did the original prostate biopsy show? Doctors use a scoring system to help determine how aggressive your prostate cancer appeared under the microscope.
  • Do you have any symptoms now that might be related to your prostate cancer? Your doctor can review the possible symptoms with you.
  • Did you develop any side effects from the radiation?
  • How is your general health? If you have other major health issues that might shorten your life, you might not want to begin any new therapy, unless the prostate cancer started causing symptoms.

If you were to start additional treatment, hormonal therapy would likely be the next step. The aim of this therapy is to decrease your testosterone (male hormone) levels. Testosterone stimulates growth of prostate cancer cells. By blocking testosterone, prostate cancer can stop growing and even shrink.

There is no rush to start hormonal therapy. You won’t lose anything by waiting a few months in most cases.

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