Will a PSA level ever be undetectable after prostate cancer?

A fellow caregiver asked...

My husband had a radical prostatectomy in May 2008 after a biopsy showed gleason levels of 7, 8 and 9, and his PSA (prostate specific antigen) level had gone from 4 to 11.4 in three months. After surgery, his PSA level was undetectable and he was placed on hormone therapy. Almost one year later, his PSA lelvel rose from .2 in January to 1.1 in April. His hormone therapy is continuing, with taxotere chemotherapy starting late May. He is just over half-way done with the chemo course of 9 months. His PSA is now .4, and was .4 last month.

What level can we realistically expect his PSA to be and stay "okay"? Can we ever expect to be cancer-free? Two doctors have told us to look at the trend of the PSA, rather than the number at any particular point. I'm having trouble coming to terms with the PSA level not being "undetectable". Should we be prepared for a higher level PSA as a norm?

Expert Answer

Linda Ackerman, R.N. has clinical experience in oncology, women's health, and medical nursing. She has been practicing for more than 20 years and is a licensed registered nurse in both Florida and Wisconsin. In addition, she serves as a board member of Breast Cancer Recovery and the Wisconsin Cancer Council.

It sounds like your husband has undergone multiple types of treatment for his diagnosis of prostate cancer.

In addition, to your husband's diagnosis of cancer, and current treatment, other factors could affect his PSA level such as hormone therapy, and age.

The PSA level is just one piece of information physicians use to determine treatment and prognosis for a prostate cancer diagnosis.
It is typical that an oncologist will look at more of a trend with PSA numbers rather than focusing on one value. A physician would also take into consideration your husband's clinical/physical condition.

To respond to your question about PSA level being undetectable, a normal PSA level for a man without prostate cancer is around 4, given that, a PSA level is typically detectable.

Based on your description of your husband's treatment, it appears that his physicians are following the standards of care related to his prostate cancer.

I would encourage you and your husband to speak with his personal physician related to your questions about being cancer free as well as asking your physician to talk more specifically about his PSA range.