A common treatment for prostate cancer is radical prostatectomy (RP), where the prostate gland is surgically removed. After surgery, doctors monitor your prostate-specific antigen (PSA) levels to watch for signs of the cancer coming back. If the PSA level becomes detectable, it’s called biochemical recurrence (BCR).
In the past, “detectable” might have meant any reading above zero. Now, doctors often use a threshold of 0.03 ng/mL or higher to define BCR.
If your PSA level rises immediately after surgery, that’s obviously a concern. However, some men have undetectable PSA levels for a while, only to see it rise later. This is sometimes called “delayed detectable PSA” or “delayed biochemical recurrence,” and it’s generally defined as a detectable PSA level more than six months after surgery.
What does it mean if you have a PSA level that remains undetectable after 3 years, but then rises? That’s what we’ll explore in this article. We’ll look at the natural history of this situation, what factors might influence it, and how doctors typically manage it. We’ll also examine long-term outcomes like metastasis-free survival (MFS), prostate cancer-specific mortality (PCSM), and overall survival.
Specifically, we’ll look at the characteristics of men who experience this delayed PSA recurrence, what influences treatment decisions, and how effective salvage therapies are in these cases.
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