Question 1

What is Post-Prostatectomy PSA Persistence?

Accepted Answer

Post-prostatectomy PSA persistence is the continued presence of detectable prostate-specific antigen levels in the blood after surgical removal of the prostate gland. It is caused by residual prostate tissue or cancer cells that remained after surgery. The Prostate-Specific Antigen (PSA), Ultrasensitive, Post Prostatectomy test is the most important test for detecting persistent PSA levels that standard tests would miss.

Question 2

What causes post-prostatectomy PSA persistence?

Accepted Answer

Post-prostatectomy PSA persistence is caused by residual prostate tissue or cancer cells that remained in the body after surgical removal of the prostate gland. Since the prostate is the primary source of PSA production, any detectable PSA after surgery indicates that some prostate cells are still present. This can occur when cancer cells had spread beyond the prostate capsule before surgery, when surgical margins were positive (cancer cells at the edge of removed tissue), or when microscopic cancer deposits existed in nearby lymph nodes or tissues that were not removed during the procedure.

Question 3

What is the best test for post-prostatectomy PSA persistence?

Accepted Answer

The Prostate-Specific Antigen (PSA), Ultrasensitive, Post Prostatectomy test is the most important test for detecting PSA persistence after prostate removal because it can detect extremely low levels of PSA that standard tests would miss. While normal PSA tests typically measure down to 0.1 ng/mL, this ultrasensitive version can detect levels as low as 0.01 ng/mL or even lower. Since PSA should fall to undetectable levels after successful prostate removal, any persistent detectable PSA—even at very low levels—could indicate residual disease or early recurrence, making early detection critical for timely intervention and treatment planning.

Question 4

When should I get tested for post-prostatectomy PSA persistence?

Accepted Answer

You should get tested starting 6 to 8 weeks after your prostatectomy surgery, as this allows enough time for PSA levels to drop to their post-surgical baseline. Your doctor will typically recommend follow-up testing every 3 to 6 months for the first few years, then annually if levels remain undetectable. Get tested immediately if you experience any symptoms such as bone pain, urinary problems, or unexplained weight loss, as these could indicate cancer recurrence. Men with higher-risk prostate cancer features (high Gleason score, positive surgical margins, or advanced stage at diagnosis) should follow a more frequent testing schedule as recommended by their oncologist.

Question 5

What are the symptoms of post-prostatectomy PSA persistence?

Accepted Answer

Post-prostatectomy PSA persistence typically has no symptoms in its early stages, which is why regular PSA monitoring is essential. Most men with persistent or rising PSA levels feel completely normal and only discover the problem through blood testing. However, if cancer recurrence progresses, you might eventually notice bone pain (especially in the back, hips, or pelvis), difficulty urinating or changes in urinary flow, blood in urine or semen, unexplained weight loss, fatigue, or swelling in the legs. The absence of symptoms does not mean there is no problem, making ultrasensitive PSA testing the only reliable way to detect persistent disease early when treatment is most effective.

Question 6

Who is at risk for post-prostatectomy PSA persistence?

Accepted Answer

Men at highest risk for PSA persistence include those with high-grade prostate cancer (Gleason score 8 to 10), positive surgical margins (cancer cells found at the edge of removed tissue), seminal vesicle invasion, lymph node involvement, or cancer that had spread beyond the prostate capsule before surgery. Additional risk factors include high PSA levels before surgery (especially above 20 ng/mL), advanced tumor stage at diagnosis, and extensive cancer involvement within the prostate gland. Men with these risk factors require more intensive post-surgical monitoring with ultrasensitive PSA testing to catch any persistence or recurrence as early as possible.

Question 7

What happens if post-prostatectomy PSA persistence is left untreated?

Accepted Answer

Untreated PSA persistence can lead to cancer recurrence and progression that becomes much harder to treat. Persistent PSA indicates active cancer cells that will continue growing and potentially spreading to lymph nodes, bones, and other organs. Early detection through regular ultrasensitive PSA testing allows for salvage treatments like radiation therapy, hormone therapy, or additional surgery when they are most effective. Once cancer spreads to bones or distant organs (metastatic disease), treatment becomes focused on control rather than cure, and quality of life can be significantly impacted. Men who ignore persistent or rising PSA levels may lose the opportunity for curative treatment options.

Question 8

Can post-prostatectomy PSA persistence be diagnosed with a blood test?

Accepted Answer

Yes, post-prostatectomy PSA persistence is diagnosed exclusively through blood testing, specifically with an ultrasensitive PSA test. Standard PSA tests used before surgery are not sensitive enough to detect the very low levels that matter after prostatectomy. The ultrasensitive version can measure PSA down to 0.01 ng/mL or lower, allowing detection of minimal residual disease. PSA persistence is typically defined as a detectable PSA level 6 to 8 weeks after surgery, or two consecutive PSA values of 0.2 ng/mL or higher. No imaging test or biopsy can reliably detect such small amounts of residual cancer—only blood testing with ultrasensitive PSA provides this critical early warning.

Question 9

How is post-prostatectomy PSA persistence treated?

Accepted Answer

Treatment for PSA persistence depends on the PSA level, rate of rise, and individual risk factors. Salvage radiation therapy to the prostate bed is often the primary treatment when PSA persistence is detected early, with cure rates of 50 to 70 percent when PSA is below 0.5 ng/mL. Hormone therapy (androgen deprivation therapy) may be added to radiation or used alone for men with higher-risk features or rapidly rising PSA. Some men with very slowly rising PSA may be candidates for active surveillance with close monitoring. Advanced cases may require combination treatments including chemotherapy, newer hormone therapies, or immunotherapy. Early detection through ultrasensitive PSA testing provides the best opportunity for successful salvage treatment.

Question 10

How can I prevent post-prostatectomy PSA persistence?

Accepted Answer

While you cannot completely prevent PSA persistence if cancer cells existed beyond the surgical margins, choosing an experienced surgeon and appropriate treatment approach for your specific cancer can minimize risk. Neoadjuvant therapy (hormone treatment before surgery) may be recommended for high-risk cancers to shrink tumors before removal. Adjuvant radiation therapy immediately after surgery may be recommended for men with high-risk features rather than waiting for PSA persistence to develop. Maintaining overall health through regular exercise, a plant-based diet rich in cruciferous vegetables and tomatoes, maintaining healthy weight, and avoiding smoking may support better outcomes. Most importantly, strict adherence to your post-surgical PSA monitoring schedule ensures any persistence is caught at the earliest possible stage when salvage treatment is most effective.

Question 11

What can I do at home for post-prostatectomy PSA persistence?

Accepted Answer

While PSA persistence requires medical treatment, you can support your overall health and potentially slow cancer progression through lifestyle measures. Adopt an anti-inflammatory diet rich in cruciferous vegetables (broccoli, cauliflower, Brussels sprouts), tomatoes (high in lycopene), green tea, fatty fish, and minimal processed foods. Regular exercise (at least 150 minutes per week of moderate activity) has been shown to improve prostate cancer outcomes and reduce progression risk. Maintain a healthy weight, as obesity is associated with more aggressive cancer. Consider stress-reduction techniques like meditation, yoga, or counseling to support mental health during this challenging time. Some men explore supplements like vitamin D, omega-3 fatty acids, or pomegranate juice, but always discuss these with your oncologist as they may interact with treatments. These measures complement—but never replace—medical treatment and regular PSA monitoring.

Question 12

How’s this work?

Accepted Answer

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Question 13

How do I know which test to get?

Accepted Answer

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Question 14

When will my lab results be available?

Accepted Answer

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Question 15

Is it possible to make changes to my lab order if I made a mistake with the name, date of birth, or any other details?

Accepted Answer

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Question 16

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Accepted Answer

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Question 17

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Accepted Answer

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Question 18

How can I find a lab location near me?

Accepted Answer

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Post-Prostatectomy PSA Persistence Blood Test

What is Post-Prostatectomy PSA Persistence?

What causes post-prostatectomy PSA persistence?

What is the best test for post-prostatectomy PSA persistence?

When should I get tested for post-prostatectomy PSA persistence?

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