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PSA levels: Can they rise after prostate removal?
By Mayo Clinic staffOriginal Article: http://www.mayoclinic.com/health/prostate-cancer/HO00032
- With Mayo Clinic urologist
Erik P. Castle, M.D.
read biographyclose windowBiography of
Erik P. Castle, M.D.
Erik P. Castle, M.D.
Dr. Erik Castle is a board-certified urologist who joined the Mayo Clinic staff in Arizona in 2007.
Dr. Castle is an associate professor of urology at College of Medicine, Mayo Clinic, and a senior associate consultant in the Department of Urology, where he also is assistant residency coordinator.
He was an assistant professor in the Department of Urology at Tulane University in New Orleans from 2004 to 2006 after serving as a clinical instructor/fellow at Mayo Clinic in Arizona for one year.
Dr. Castle's research interests include prostate cancer, bladder cancer and kidney cancer. He is the director of the Desert Mountain Prostate Cancer Research Fund and is the principal investigator of Castle labs housed at the Samuel C. Johnson Medical Research Building at Mayo Clinic in Arizona. His basic science research is focused on novel secondary hormonal therapies of prostate cancer as well as genomics of prostate and bladder cancers.
His surgical expertise includes laparoscopic urology, robot-assisted radical prostatectomy with nerve sparing, robot-assisted radical cystectomy with neobladder, robot-assisted retroperitoneal lymph node dissection, robot-assisted partial nephrectomy and other robotic urologic oncology procedures. He has performed many of these procedures as demonstrations internationally. He is a member of the American Association of Clinical Urologists, the American Urological Association, the Endourological Society, and the Society of Laparoendoscopic Surgeons. He is past president of the international Society of Urologic Robotic Surgery. He is also the director of the international laparoscopic nephrectomy courses throughout Mexico on behalf of the American Urologic Association.
Complications (1)
- Bladder outlet obstruction: Causes in men?
Treatments and drugs (1)
- PSA levels: Can they rise after prostate removal?
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Question
PSA levels: Can they rise after prostate removal?
What causes PSA levels to increase after prostate removal due to benign prostatic hyperplasia (BPH)?
Answer
from Erik P. Castle, M.D.
Increased levels of prostate-specific antigen (PSA) in your blood can be a sign of prostate cancer. However, cancer is just one of several possible causes of increased PSA.
It's normal for prostate tissue to release small amounts of PSA into your bloodstream. When the prostate grows, PSA levels increase. When the prostate is removed, PSA levels fall close to zero. Most procedures done for an enlarged prostate remove only part of the prostate, which partially decreases PSA levels. A small amount of prostate tissue may remain even after procedures that are considered a total removal of the gland. After any of these enlarged prostate procedures, a number of things can cause PSA levels to go up again. They include:
- Prostate cancer. Prostate cancer cells in remaining prostate tissue or in other parts of your body can release PSA. Checking for signs of prostate cancer is the main reason men have PSA tests.
- Recurrent benign prostate growth. Some prostate tissue remains even if your entire prostate is removed. This tissue may continue to grow, leading to increased PSA levels.
- Inflammation of prostate tissue (prostatitis). Infection or inflammation of the prostate gland or tissue remaining after prostate surgery can cause your PSA levels to increase. Once prostatitis is treated with antibiotics, PSA levels generally return to normal.
- Recent ejaculation. Ejaculation (orgasm) can cause a temporary increase in PSA levels. To get the most accurate reading, don't ejaculate for two days before you have a PSA test.
If you have elevated PSA levels after surgery for enlarged prostate, your doctor may recommend a wait-and-see approach — advising you to retake the PSA test after two or three months. If your doctor suspects prostatitis, you may be prescribed antibiotics to cure the infection. If a second test shows high PSA levels, your doctor may recommend additional tests, such as other blood tests, urine tests or ultrasounds tests. If cancer is suspected, you may need a biopsy to check remaining prostate tissue.
Next questionBladder outlet obstruction: Causes in men?
- Prostate-specific antigen (PSA) test. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/Detection/PSA. Accessed Dec. 27, 2011.
- Getzenberg RH, et al. Prostate cancer tumor markers. In: Wein AJ, et al. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/208746819-6/0/1445/0.html. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-1-4160-6911-9..00098-0&isbn=978-1-4160-6911-9&uniqId=308994767-12#4-u1.0-B978-1-4160-6911-9..00098-0. Accessed Dec. 27, 2011.
- Prostate cancer: Early detection. American Cancer Society. http://www.cancer.org/Cancer/ProstateCancer/MoreInformation/ProstateCancerEarlyDetection/prostate-cancer-early-detection-tests. Accessed Dec. 27, 2011.
- Nippoldt TB (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 30, 2011.
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