After surgery

After radical prostatectomy, PSA tests are used to evaluate the success of the surgery and to monitor for disease recurrence. An undetectable PSA level (usually less than 0.2 ng/mL) after radical prostatectomy indicates that all the prostate tissue (both benign and malignant) has been removed. A detectable PSA immediately after surgery means that the tumor had already spread to other tissues before the surgery and thus could not be totally removed. A subsequent rise in PSA levels indicates the cancer has recurred in the area of the prostate or in another place in the body.

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For men with cancer confined to the prostate (stage T1 or T2) before treatment, the chance of a cancer recurrence—indicated by detectable PSA levels—10 years after treatment is around 30 percent. A detectable PSA indicates a cancer recurrence months to years before the cancer is visible by a CT or bone scan. When evidence indicates that residual cancer is limited to the pelvis, radiation therapy is a treatment option. A detectable PSA in the first year after treatment indicates a high probability that the disease has spread beyond the pelvis and that radiation will not successfully eradicate the cancer. In this case, hormone therapy is considered, particularly if the cancer has spread to the bones.