Dog after radical prostatectomy: frequency of testing

The prostate gland can be completely removed. This also removes all the lymph nodes surrounding the organ. This procedure is called radical prostatectomy .

RP is recognized as a fairly effective operation, which is indicated for cancer at the first and second stages.

The result is positive, treatment allows you to achieve the main goal: increase life expectancy and improve its quality. At the same time, there is an increase in life expectancy when undergoing RP by an average of 13 years.

The organ is completely removed. As a result, the level of antigen produced in the prostate is significantly reduced. Pathological processes may also develop: PSA decreases less than it should be.

Sometimes this happens under the influence of negative factors, but in some cases it becomes an alarming signal of the development of a relapse.

They take a PSA test after radical prostatectomy. The result must be objective, so it is recommended to properly prepare for the test.

In this case, the specialist will be able to correctly consider the dynamic changes in the level of antigen in the body when surgery to remove the prostate has already been performed.

PSA values ​​after surgery: changes

It is known that PSA is an enzyme-type protein. It is produced in small quantities in the mammary and paraurethral glands, but is mainly produced in the prostate gland.

As a result, when conducting tests, the antigen is considered to be a marker specific to the prostate gland. Its content is determined in venous blood.

It is important to understand that it is natural for the male body to change the level of PSA depending on the age period. Here are specific numbers to indicate the difference in antigen content at specific age intervals:

• 2.5 ngml at 40-49 years old;
• 3.5 ngml in 50-59;
• 4.5 ngml at 60-69.

After 70 years, the level can reach 6.5. When it is known what the PSA value should be in a healthy person, an increase in values ​​can be determined.

Prostate cancer provokes a sharp increase in enzyme production. The level jumps several times. Typically, malignant changes provoke an increase in the indicator to 20 units. If there is a jump to a level of 10 units, we can talk about suspicion of cancer development.

Also, such a symptom indicates benign prostatic hypertrophy, the progression of prostatitis, and all kinds of inflammatory and infectious processes.

Prostatectomy usually causes a decrease in antigen concentration. It is recommended to test the blood during the period when more than three months have passed since the operation. As a last resort, it is possible to perform the analysis after 6 weeks. This happens in cases where there is already a need for urgent diagnosis.

A certain period of time is needed to stabilize protein production during the body’s recovery after surgery.

When an operation was performed not long ago, an inflammatory process is observed in the body, characteristic of the postoperative period. It is precisely in this case that it is impossible to obtain objective research results.

Based on the hormone level readings, one can conclude that the disease has relapsed, although in fact this indicates a normal transitional postoperative period .

Normal PSA after RP

The norm of the dog after radical prostatectomy is known. The volume should be approximately 0.2 ng/ml. Experts consider the limit to be 0.7 ng/ml .

If this threshold is exceeded, we can immediately speak of a risk zone. Additional diagnostics will be required . Appropriate therapy is prescribed to restore the optimal process of antigen production.

Getting the PSA test done correctly

After prostatectomy, it is important to determine whether there is a need for further surgery. Here analysis alone will not be enough. The dynamic change in the level of antigen in the body must be determined .

A specific period of time for conducting research is determined. Depending on the results of the tests, the frequency of their delivery is then established. It is enough to carry out the study only once over three months if the PSA level remains within acceptable values. Then just one analysis per year is enough.

As soon as it is determined that the concentration of an element in the blood is exceeded, it is important to begin taking tests regularly. You will need to test your blood once a month . It is necessary to determine whether there is a relapse, identify it in time, and perform surgery.

You should properly prepare for the PSA blood donation procedure. Proper preparation from certain steps:

• It is important to minimize physical activity three days before the test;
• masturbation and intimate life are excluded about a week before the expected blood draw;
• from the moment of visiting a urologist and carrying out various diagnostics, about three weeks should pass, since the examination also implies a certain effect on the body in the genital area;
• Smoking also distorts the picture, so you should quit it at least 24 hours before;
• blood is taken on an empty stomach, so food is limited 10 hours before the test;
• Caffeinated drinks and alcohol are also prohibited 2-3 days before the test.

If you follow all the requirements, you can get objective information about PSA production after prostate removal.

What affects the accuracy of the analysis

When radical surgery has already been performed, it is extremely important to detect relapse . The antigen test is becoming the optimal diagnostic tool, sensitive and quite accurate.

Recurrent development of the disease can be detected by tomography and histological examination, but objective results will appear quite late.

Sometimes such diagnosis becomes effective only after a year or two, and this is already too late given the rapid progression of the disease. The PSA indicator will signal a relapse much earlier, on average by 6 months.

That is why experts advise preparing in advance for the test and taking all necessary measures. Then the diagnosis will really give reliable results.

Here are some significant factors that affect PSA levels:

• deep prostate massage (this is excluded 3 days before);
• Ultrasound, TRUS, CT and MRI (a week should pass);
• mechanical impact on the prostate area, ejaculation (they refuse this in a couple of days);
• taking various medications, especially hormonal ones (it is important to stop taking medications a week before the test);
• prostate biopsy (takes two weeks to recover).

Causes of elevated PSA levels

It is very important to carefully follow absolutely all recommendations in the process of preparing for submitting the material for analysis. Any impact can affect the functioning of the glands of the genitourinary system, which will provoke increased production of PSA.

For example, you should not massage the prostate, ride a bicycle, or experience excessive physical activity. The study will have distorted results if the preparation regime for them was violated.

The specialist will try to determine whether the tests are false. If there is any doubt about the reliability of the data, the diagnosis is repeated .

Here are some reasons why PSA levels increase after RP:

• genitals are injured;
• metastases occurred on tissues and organs that were located near the tumor;
• not all areas of the tumor are eliminated, but the remaining areas begin to develop and grow;
• there are complications after surgery, for example, allergies to drugs, infections;
• There is an inflammatory process in the genitourinary system.

Relapses develop after surgery quite often. The risk of developing prostate cancer again is about 37.5% . We are talking about a relapse in the next 10 years.

It is not possible to significantly reduce the rate, even if you undergo special therapy to prevent relapse of the disease. Cancer treatment is quite difficult, with various complications.

What to do if your PSA level is elevated

After surgery, antigen production sometimes remains excessively high. In this case, there is a need for additional treatment .

The specific treatment regimen depends entirely on the type of relapse: it can be systemic or local . It is possible to diagnose the type of relapse if the PSA dynamics are properly monitored after surgery.

• When there are distant metastases, the tumor has already spread beyond the prostate, we can talk about the presence of a systemic relapse . And the phenomenon of abnormal growth will be reflected in the antigen level quickly - about six months after surgery.
• Local relapse is also possible . It is characterized by localization of the tumor in the same area where the operation was performed. Only after 2-4 years can this be determined by the PSA content.

If you make your diet richer, include fruits and vegetables, pomegranates and tomatoes, consume more vitamins and valuable minerals, you can significantly reduce the risk of inflammatory processes in the prostate.

Selenium with zinc and vitamin C are useful. They inhibit the proliferation of free radicals.

© 2018 - 2019, Eganov Egan Pavlovich. All rights reserved.

Source: https://ZdravMen.ru/diagnostika/psa-posle-prostatektomii.html

Dog after radical prostatectomy: acceptable level, treatment, advice and reviews

• September 26, 2018
• Prostatitis
• Belyak Inna

The prostate gland is often underestimated by the male population. However, problems in her health, especially cancer pathologies, inevitably affect the quality of everyday life. Any man should be attentive to his prostate health and undergo regular preventive examinations.

The role of the prostate in the male body

The prostate is an organ of the male reproductive system that performs a number of very important functions. Without stable functioning of the prostate gland, malfunctions may occur both in the genitourinary area and in nearby organs, and even in a person’s mental state.

The prostate takes over and performs the following tasks:

1. Produces a secretion that takes part in the formation of seminal fluid. Without this secretion, sperm do not receive the necessary protection and assistance in the process of fertilizing the egg.
2. Muscle tissue, which is also part of the prostate, helps prevent urine from entering the seminal fluid, which allows sperm to survive longer.
3. The work of the prostate gland is also aimed at protecting the body from the penetration of infections through the urethra.

There is an opinion that the prostate gland is an organ necessary for a man’s quality of life. In many ways, this opinion is correct, but there are a number of pathologies that lead to sad consequences.

For example, when diagnosing prostate cancer, the doctor may decide to completely remove the prostate (radical prostatectomy). In the initial stages of oncology, this approach helps prevent further damage to the body.

Radical prostatectomy: what is it?

Radical prostatectomy is the complete removal of the prostate and is a fairly common procedure to eliminate cancer in its early stages. To make a decision about surgery, a number of factors must be taken into account:

• The cancer is limited to the prostate gland.
• The patient's age does not exceed 70 years, and his health indicators allow the operation to be performed.
• There are no individual structural features of the reproductive system that do not allow surgical intervention.

During the operation, not only the organ itself is removed, but also the tissues that surround it, as well as the lymph nodes. This approach reduces the likelihood of cancer recurrence. Do not forget that such an operation is extremely stressful. Any intervention in the integrity of the body is not easily tolerated; in the case of the prostate, the problem may also have a psychological background.

Often, several months pass between the appointment and the operation, during which the man is prepared for surgery. During the period of active preparation, it is important to carefully follow medical recommendations, not to neglect medical measures, and to properly prepare for further recovery.

Prostatic antigen - what is it?

PSA is a prostatic antigen. After prostatectomy, PSA is monitored with increased vigilance. This antigen is a protein produced by the prostate gland. A change in its level in the body can signal pathological and dangerous processes.

Studying PSA after radical prostatectomy allows for timely detection of the risk of cancer relapse. If the indicator is assessed before the operation, then, most likely, it is its level that will indicate the presence of pathology and prompt a more thorough diagnosis.

PSA levels after radical prostatectomy are assessed by the attending physician. A good specialist will be able to timely evaluate the data obtained and make a prompt decision on further treatment.

Purpose of the analysis

If a jump in the amount of antigen is observed in the male body, this indicates the appearance of cancer in the prostate gland.

Correct PSA assessment after radical prostatectomy is essential. It allows you to determine the success of the operation and the ability of the man’s body to recover.

The amount of antigen protein should gradually decrease, but this process does not happen instantly, it will take time.

When collecting biomaterial for PSA after radical prostatectomy, it is important to conduct studies when the patient’s general health condition has stabilized. Otherwise, this event will be useless.

It is difficult to establish uniform timing for analysis. The doctor evaluates the patient’s individual indicators, on the basis of which he makes a decision on PSA assessment. Timely analysis will be indispensable in assessing the prospects for recovery.

Rules for taking analysis after surgery

PSA values ​​obtained after radical prostatectomy are key, but it is important to follow the rules during the procedure. Any deviation can lead to an error in the results, which will mislead the doctor and the patient and subject them to additional stress.

Rules for preparing a patient for a PSA test:

1. Blood is taken exclusively on an empty stomach; only plain still water is allowed to be consumed (refuse food 8-10 hours before the test).
2. It is also recommended to refrain from smoking 10 hours before the test, if such a habit is present.
3. Limit the consumption of fried, salty, smoked and fatty foods, do not drink coffee and alcohol (at least one day before the test).
4. Avoid stress and physical fatigue on the eve of the analysis.
5. If drug treatment is carried out, make sure that it does not affect PSA values.
6. Adjust the schedule of additional procedures, avoid ultrasound, x-rays, MRI and radiation exposure for several weeks before the PSA test.

To obtain a complete picture of health, a PSA test is taken several times after radical prostatectomy. The doctor observes the behavior of the body in dynamics. The first procedure is scheduled on average 5-6 months after surgery.

How key indicators may change

The main question that worries most patients is what PSA after radical prostatectomy is considered normal? There are two options:

1. Successful surgery and blocking the development of cancer will reduce the level of antigen in the blood.
2. An increase in PSA after radical prostatectomy indicates that cancer continues to affect the body. In such cases, additional hormonal therapy or a course of radiation is prescribed.

Medical studies have shown that the decrease in PSA is due to the removal of the prostate gland, the channels that produce antigen. It is generally accepted that after radical prostatectomy, PSA should not exceed 0.4 ng/ml.

Oncology can recur within several years after surgery. For this reason, the test must be taken regularly, and the doctor must monitor the dynamics. If there is a suspicion of cancer reappearance, the frequency of biomaterial sampling increases (analysis is carried out once a month).

What can affect the accuracy of the analysis

The reliability of the analysis depends on proper preparation of the patient and compliance with the basic rules of the procedure. The preparation rules are described in detail above. In this case, it is important to adequately assess the patient’s condition and make sure that he has recovered as much as possible after the operation.

An increase in PSA may also indicate the following:

1. In a man, an inflammatory process develops in the body of the genitourinary system.
2. Infection or allergy to medications.
3. Recurrence of cancer, as mentioned above.
4. The main tumor was eliminated, but metastases remained in other areas.
5. If the genitals have been subjected to external mechanical trauma, the result will be inaccurate.
6. Increased physical activity on the eve of the analysis will lead to distorted results.

It is important to understand that if the analysis is carried out incorrectly, an increase in PSA can sow panic in the soul about a recurrence of cancer, but in fact be a consequence of non-compliance with medical recommendations. When it comes to treating oncology, there are no minor or unimportant rules.

What is the PSA norm?

Any blood test in a person is an individual indicator that reflects the general condition of the body. The response to radical prostatectomy also varies from person to person. However, in modern medicine it is customary to highlight the limits that are considered normal PSA after radical prostatectomy. The age of the man plays an important role in this matter:

• 40-50 years – 2.5 ng/ml.
• 50-60 years – 3.5 ng/ml.
• 60-70 years – 4.5 ng/ml.
• Over 70 years – up to 6.5 ng/ml.

The established standards apply to men who have not encountered cancer. If the prostate is completely removed from the body, the PSA level should be below 2.5 ng/ml.

Doctors' advice and patient reviews

Doctors pay attention to the features of prostate cancer. The disease develops over a long period of time without showing any symptoms. For this reason, experts advise mature men (especially those over 40 years old) to regularly consult a doctor for a preventive examination. This will allow timely identification of a dangerous disease and elimination of it in the early stages.

Based on reviews from patients who have undergone prostate removal surgery, it becomes clear how important it is to follow medical recommendations. If oncology is detected, it is contraindicated to self-medicate or neglect laboratory tests.

When interacting with a competent specialist, a schedule of necessary procedures will be drawn up. After prostatectomy, PSA levels are constantly monitored; this is not a whim of the doctor, but a guarantee of the patient’s future health. This approach will extend human life.

Source: https://cureprostate.ru/418221a-psa-posle-radikalnoy-prostatektomii-dopustimyiy-uroven-lechenie-sovetyi-i-otzyivyi

Dog after removal of prostate cancer and radiation therapy: norms and causes of deviations

PSA is the abbreviated name for prostate-specific antigen. This is a protein that is produced by the prostate. The antigen content in the blood of completely healthy men is minimal, but depends on age.

An increase in PSA compared to normal may indicate a pathology associated with the prostate gland, including a malignant neoplasm.

In the article we will consider the question: what are the normative values ​​of PSA after prostate cancer surgery, how to obtain objective analysis data.

Why get a prostate specific antigen test after surgery?

Determining the level of antigen in the blood is performed for the following purposes:

• diagnosis at an early stage of diseases of the genitourinary system that occur without symptoms or with not very pronounced signs. These can be both neoplasms and infectious diseases;
• determining the degree of effectiveness of prescribed treatment measures. If the level of antigens decreases significantly, this indicates positive dynamics in the course of the disease;
• timely detection of cancer relapse after treatment;
• cancer prevention. An increase in PSA levels over the course of a year indicates a risk of disease.

Preparation and features of the analysis

In order for the results of the study to be as informative as possible, it is important to follow the following recommendations before submitting the analysis:

• two days before taking a blood test, you should adhere to a diet: refrain from fried, salty, spicy, fatty foods, meat and alcoholic beverages. Steamed vegetable dishes, porridges, as well as soups made with water or vegetable broth are recommended;
• stress and physical activity should not be allowed;
• you should refrain from intimacy and masturbation;
• 12 hours before blood sampling for analysis, you should not eat. You can drink some still water;
• You should not smoke 2 hours before the diagnostic procedure.

In addition, other procedures affect the accuracy of prostate specific antigen levels.

The minimum time for procedures before analysis is:

• Ultrasound, X-ray diagnostics – 7 days;
• prostate massage – 3 days;
• prostate biopsy – from 1.5 to 2 months;
• taking medications (Methotrexate, Proscar, Cyclophosphamide) – from 10 to 14 days;
• cycling – 1 day;
• masturbation, sexual intercourse, accompanied by ejaculation – 1 day.

PSA norm after prostate cancer removal

The most common methods of treating oncology are radical removal of the gland and radiation therapy. The standard tumor marker values ​​after these types of therapy are different.

PSA level after radical surgery

During prostatectomy, the prostate gland affected by the tumor is removed along with surrounding tissue. In this case, it is recommended to take a PSA test 1-1.5 months after surgery. Immediate testing does not make sense, since the high level of antigen will persist for some time.

The frequency of donating blood for analysis is:

• with normal PSA (less than 0.2 ng/ml), the antigen level is determined during the first year once every 3 months. At the end of the first year, testing is carried out once every 6 months;
• if the PSA value is at or above 0.2 ng/ml, then a monthly test is performed. This allows you to identify a relapse at an early stage and prescribe adequate therapy with a 100% guarantee of cure.

The limiting PSA level after radical surgery is 0.2 ng/ml. If the actual value is greater than the specified maximum, this indicates a possible recurrence of cancer.

To exclude false positive results, the patient is prescribed repeat testing.

An increase in PSA in the blood after radical surgery to remove the gland can be caused by the following reasons:

The probability of prostate cancer returning in the first 10 years after surgery, even with adequate therapy, is about 37%. This is quite a big risk. The choice of treatment for a high PSA value depends on the type of relapse (systemic or local).

Relapse is determined by monitoring the antigen level over a long period of time:

• local relapse means localization of the tumor within the previously operated area. Exceeding the PSA norm occurs 2-4 years after the intervention;
• if there are distant metastases, they say that a systemic relapse has occurred. An abnormal increase in PSA levels in this type of relapse occurs less than a year after surgery.

If the patient was prescribed radiation therapy, the magnitude of the PSA decrease is 0.5 ng/ml.

This is explained by the fact that irradiation only partially destroys foreign cells. The part of the “surviving” tumor contributes to an increase in the level of tumor markers. With successful radiation therapy, PSA levels gradually decrease (over about 2 years).

A stable increase indicates that the tumor is “alive” and additional treatment measures are required. Contact radiation (brachytherapy) leads to a sharp jump in PSA immediately after the procedure. There is no need to be afraid of this: this is how it should be.

Prostate cancer

Frequency of testing after radiation therapy:

• when the antigen concentration drops to 0.5 ng/ml and below - once every 6 months;
• with a slow decline in the PSA value or its unchanged value - at least once every 3 months.

Additional diagnostic methods for suspected relapse

An increase in the antigen value after surgery to remove a tumor does not always indicate the return of cancer. For an accurate diagnosis, it is necessary to perform the analysis several times. Additional diagnostics help confirm or exclude relapse.

If the PSA level is elevated after surgery, then a relapse is suspected. In this case, patients are prescribed the following diagnostic procedures:

• MRI of the pelvis;
• prostate biopsy;
• PES. This innovative technique, which is widely used in the West, allows one to detect metastases in the lymph nodes even before they enlarge;
• Abdominal CT scan;
• bone scintigraphy.

The last two procedures at an early stage are practically uninformative.

Only when the antigen level increases to 40 ng/ml is there a chance of detecting a relapse.

If the value is no more than 20 ng/ml, the most informative way to find cancer is MRI.

Video on the topic

Urologist on the informativeness of the prostate specific antigen (PSA) test in the diagnosis of prostate cancer:

Cancer is an insidious disease that sometimes exhibits unpredictable “turns” in its course. Therefore, it is important to monitor the tumor marker indicator in order to take timely measures. Using the test results, the specialist adjusts the treatment.

Source: https://prostata.guru/prostata/rak-prostaty/psa-posle-operacii.html

Dog after radical prostatectomy: norm, dynamics

One of the most dangerous diseases of the prostate is cancer, which can destroy the organ. In the early stages, this disease is asymptomatic, which significantly complicates diagnosis.

If you suspect cancer, you need to donate blood to analyze the concentration of a special protein called PSA. Normally, in a healthy man, the body synthesizes a fixed amount of this protein, and a deviation from the norm occurs only with prostate cancer. The PSA level also changes after surgery to remove the prostate gland.

PSA and radical prostatectomy

Prostatectomy is an operation in which the prostate gland is completely removed. Prostatectomy is usually prescribed in the advanced stages of prostate cancer when radiation or chemotherapy cannot cure a person.

When the prostate is removed, the concentration of PSA in the blood sharply decreases. If, after prostatectomy, cancer cells continue to multiply in the body, PSA levels will rise again.

Therefore, using a blood test, you can determine whether the surgery was effective or not.

PSA level after prostate removal

Normally, a man with a healthy prostate gland has a PSA concentration of 0-5 ng/ml. However, the concentration of this protein differs slightly depending on age:

• up to 50 years – no more than 2.5 ng/ml;
• 50-60 years – no more than 3.5 ng/ml;
• over 60 years old – no more than 5 ng/ml.

If the blood test shows a significant excess (more than 5 ng/ml) of PSA, most likely the patient still has prostate cancer.

In some cases, a short-term slight increase in PSA may occur due to natural causes, but a persistent increase clearly indicates the presence of cancer.

For example, if a 40-year-old man has a blood test and it turns out that his PSA concentration is 3 ng/ml, it is recommended that he donate blood again in a couple of months.

However, if a 45-year-old man has a PSA concentration of 10 ng/ml, then this is a clear sign of cancer.

After removal of the prostate, the hormone concentration should be 0-0.2 ng/ml, although in some cases it can be exceeded to 0.4-0.5 ng/ml. In this case, blood should be tested not immediately, but 2-3 months after the operation, since the protein concentration decreases after some time.

Also important is not only the absolute concentration of PSA in the blood, but also the dynamics of changes in its concentration. Therefore, after a prostatectomy, it is necessary to donate blood for analysis at least once a year.

If after prostatectomy the analysis showed that the hormone concentration is more than 0.5 ng/ml, this means that the cancerous tumor has resumed its growth and/or metastasized to other organs. In this case, the doctor must conduct additional studies to determine the presence of a tumor and select the optimal treatment:

• If after removal of the prostate the tumor is localized in the pelvic area, the PSA level does not increase immediately, but 2-3 years after the operation. In this case, local radiotherapy is usually used.
• If the tumor has metastasized to other organs, the PSA level rises almost immediately after removal. In this case, a comprehensive diagnosis is required, and chemotherapy, radiation and surgery can be used as treatment methods, if removal of the infected organ is possible.

Preparing for analysis

Blood is taken from a vein for analysis, and the procedure is carried out in a hospital in a standard way. When donating blood for analysis, you must adhere to special recommendations, since otherwise the results may be distorted:

1. 3 days before donating blood, you should refrain from sexual intercourse, since during sex the PSA concentration in the blood increases by 2-3 points, and the deviation can persist for 48 hours.
2. Physical activity also affects PSA, so it should be avoided 2 days before the test. Almost all sports are banned. Leisurely walking distances of no more than 1 km are allowed. If the patient's profession involves heavy physical labor, it is necessary to take several days off for health reasons.
3. For 1 day you need to give up junk food: fast food, canned food, fried foods, as well as alcohol, tobacco and coffee.
4. It is best to donate blood in the morning on an empty stomach. The last meal should take place 8-10 hours before the test. In the morning before donating blood, you are allowed to drink mineral water without gas.

So, normally a man’s PSA concentration in the blood is 0-5 ng/ml. After removal of the prostate, the amount of this protein should drop to 0-0.5 ng/ml. In this case, the PSA level does not decrease immediately, but 2-3 months after surgery to remove the prostate.

If the analysis showed that the PSA level is above 0.5 ng/ml, this is a sign that not all cancer cells were destroyed during the operation, and the tumor began to grow again. In this case, the doctor must conduct additional diagnostics and select a new treatment.

You need to donate blood for analysis several times, since not only the protein concentration, but also its dynamics matters to the doctor.

© 2018 – 2019, MedProstatit.ru. All rights reserved.

Source: https://MedProstatit.ru/psa-posle-radikalnoj-prostatektomii.html

PSA level after radical prostatectomy

In case of severe growth of benign prostatic hyperplasia or in the case of the development of a malignant neoplasm, a special surgical intervention is prescribed - prostatectomy. After it, the level of PSA (prostate-specific antigen), a protein substance that is formed in the tissues of the prostate gland in men, should decrease, which indicates regression of the disease.

The dog and its normal content

Prostate-specific antigen is produced to protect germ cells from environmental factors and is also responsible for the thickness of seminal fluid. It is produced by the cellular structures of the prostate gland, and in small quantities by the mammary and periurethral glands.

PSA is found in two forms in the body:

• bound - combines with other substances and is not active;
• free - in active form.

It is impossible to calculate the total amount of prostate-specific antigen produced, so only its free form is taken for calculations. This is often enough for the timely detection of a malignant neoplasm.

Surgery can be prescribed only when antigen levels are within 20 ng/ml. Otherwise, the operation is postponed and a special course of chemotherapy is prescribed to lower PSA levels.

What is prostatectomy

To treat cancer and benign hyperplasia, complete resection of the prostate gland is most often performed. This manipulation has proven itself well in the treatment of the initial stages of cancer pathology in people whose age has not reached 75 years.

A timely operation allows you to preserve the main bundle of innervation, which is necessary for normal erection and the ability to regulate urination. In the absence of metastases, radical prostatectomy makes it possible to get rid of the focal lesion, maintaining the man’s normal health.

But medical statistics say that in 30% of cases, even with successful surgical intervention, a recurrence of oncology is possible within a decade. For its timely detection, it is important to regularly conduct a blood test to determine the level of prostate-specific antigen.

Antigen norm before and after surgery

With a malignant neoplasm, the PSA level increases, which makes it possible to differentiate the disease through a specific blood test for biochemistry.

Before the development of oncology, the norms of PSA levels in the blood fluctuate within the following limits:

• up to 50 years - up to 2 ng/ml;
• from 50 to 65 years - up to 3.5 ng/ml;
• from 65 to 73 years - up to 4 ng/ml.

A strong excess of PSA above 4 ng/ml automatically places a man in a certain risk group with a 35% chance of developing a cancerous tumor in the prostate gland. If PSA increases to 10 ng/ml, the risk percentage increases to 50%.

After prostate resection, PSA levels decrease. The first tests are carried out 90 days after surgery. This time is necessary for maximum recovery of the body after surgery and stabilization of the internal environment.

Ideally, PSA levels after prostatectomy should not be higher than 0.2 ng/ml. But a result of 0.4–0.5 ng/ml is also considered normal. The maximum permissible value is 0.7 ng/ml.

If these indicators are exceeded, chemotherapy is prescribed. They monitor the situation over time and carry out several PSA tests in a row. This type of diagnosis allows you to quickly identify the onset of cancer relapse.

When carrying out timely diagnosis by determining PSA in the patient’s blood, it is possible to determine the systematicity or localization of the pathology process. Systemic relapse may occur six months after prostatectomy.

With a favorable clinical picture, the indicators will remain at the same level and control will weaken. During the first year after prostatectomy, blood is taken for analysis every 3 months; the next two years - every 6 months; starting from the 4th year, tests are required once a year.

Rules for taking PSA

In order to get a reliable result, you must adhere to some rules immediately before taking the PSA test:

1. Blood sampling should be carried out no earlier than 3 weeks after visiting the urologist;
2. 7 days before the expected analysis, it is necessary to suspend sexual activity;
3. reduce the amount of physical activity in advance;
4. one day before the expected prostate-specific antigen test, you need to exclude smoked, salty foods, as well as alcoholic drinks and sweets from your diet;
5. The test should be taken on an empty stomach. 8 hours before the tests, you must stop eating; drinking clean, still water is allowed;
6. Smoking is prohibited 3 hours before the test.

Biological material for research is taken from a vein in the morning. To carry out the analysis, the method of indirect hemagglutination is used.

Reasons for increased rates after prostatectomy

A high level of prostate-specific antigen does not always indicate the presence of cancer recurrence. The indicator may increase temporarily in the following cases:

• sexual intercourse followed by ejaculation of seminal fluid;
• prostate massage;
• studies using ultrasound diagnostics;
• invasive types of interventions in the pelvic organs, including biopsy of the male gland;
• inflammation processes in the urinary and reproductive systems;
• pelvic organ injuries;
• incomplete cure of the prostate gland;
• allergic reactions to medications used during surgery;
• infection of the pelvic organs during prostatectomy.

Some other related factors may also influence the result of the analysis:

• patient nutrition;
• presence of bad habits;
• increased physical activity.

Studying the levels of prostate-specific antigen in the blood is the most reliable and fastest way to detect a possible relapse of cancer. In contrast, the results of histological and visual studies can show a relapse only after a year, or even more.

Source: https://MedExpert.guru/prostata/rak/psa-posle-radikalnoj-prostatektomii.html

Dog after radical prostatectomy

The male genitourinary system is subject to the influence of numerous negative factors, both external and internal. With the onset of adulthood, it becomes increasingly difficult to avoid pathological changes in the tissues of the prostate gland.

Sometimes men are faced with diseases of this organ, and if therapy does not bring improvement, then the only chance for recovery is surgery, namely prostatectomy.

The PSA level after removal of prostate cancer is an extremely important indicator, the excess of which can signal a recurrence of the disease.

Antigens are mainly localized in the prostate, but enter the blood in small quantities. Various pathologies of the male genital organs disrupt the barrier between the gland cells and the circulatory system, allowing PSA to freely penetrate into the bloodstream.

The PSA level after surgery increases only in cases where the malignant process has not been completely stopped.

Standard indicators

A referral to determine the concentration of PSA in the blood is given by an oncologist, urologist or andrologist.

PSA levels after radical prostatectomy (RP) should be monitored every three months for 1 year, and for the next few years the man should be tested once every six months to monitor prostate-specific antigen levels.

Since during the operation the prostate is completely removed (the gland, its capsule, seminal vesicles and vas deferens), the PSA value is not immediately restored; usually its serum levels drop to the lower limit of normal.

Previously, it was believed that cancer does not develop if the PSA value does not exceed 4 ng/ml, but practice proves the opposite; even at low concentrations of the substance, cancer cells may appear.

This is explained by the fact that young people have a smaller prostate, and therefore their PSA will be lower.

Men under 40 years of age rarely need such studies, since the likelihood of the formation of malignant neoplasms in a young body without the presence of concomitant pathologies is close to zero.

 Optimal antigen indicators:

• 40–50 years – 2.5 ng/ml.
• 51–60 years old – 3.5 ng/ml.
• 61–70 years old – 4.5 ng/ml.
• Over 70 – 6.5 ng/ml.

As you can see, in healthy representatives of the stronger sex, PSA levels increase over the years. A value of 4–10 ng/ml does not always indicate cancer; cancer can develop only in 30% of cases. Doctors call a slight excess of the norm a “gray zone.”

If the removal of prostate cancer is successful, then within 2 years after surgery there will be a gradual decrease in PSA levels.

But indicators of prostate-specific substances from 50 ng/ml or more with reliable accuracy indicate the development of the process of formation of secondary foci of tumor growth (metastases) in the patient.

Remember, a specialist does not make a final diagnosis based on one result of a PSA blood test. You should definitely undergo a repeat laboratory examination.

Additionally, the doctor may prescribe an MRI of the pelvic organs and tomography of the abdominal cavity.

An increase in PSA after removal of prostate cancer is considered the main criterion by which the current condition of the male body is assessed. Relapse of cancer can be systemic or local.

A doubling of the PSA amount indicates a local relapse, but if its level begins to increase immoderately immediately after prostatectomy, then we can talk about a systemic exacerbation.

In any case, PSA levels should be monitored not only after surgery, but also for preventive purposes.

Reasons for violation of analysis results

Studies have shown that approximately 25-50% of prostatectomy patients experience cancer recurrence within the first 10 years.

At the same time, a certain percentage of men with a removed prostate undergo mandatory anti-relapse therapy.

Tumors can form regardless of the presence or absence of bad habits, sexually transmitted diseases or regularity of sexual contacts. Also, genetic predisposition does not guarantee protection against cancer.

 Reasons for increased PSA after radical treatment of the prostate:

• Inflammatory processes occurring in the male genitourinary system.
• Damage to tissue metastases of neighboring organs.
• Functioning of residual areas of the prostate (with incomplete removal of the gland).
• Nonspecific complications after surgery (purulent-septic infections or allergic reactions to drugs used during prostatectomy).
• Mechanical injuries to the genital organs.

If PSA deviates from the norm after surgery to remove prostate cancer, treatment is aimed at reducing the concentration of the antigen in the male body, which helps avoid relapse of the disease. In order to stop or slow the progression of cancer, doctors recommend the use of radiation or hormonal therapy.

By the way, radical prostatectomy lowers the PSA level to a minimum, while radiation therapy reduces the PSA level by only 1 ng/ml from the initial result.

Monotherapy with antiandrogen drugs is much easier to tolerate by patients due to mild side effects than the use of hormones in combination with potent medications.

Source: https://prostatittut.guru/prostata/rak/psa-posle-radikalnoj-prostatektomii.html