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Prostate Cancer

Determining the Effect of Cancer on the PSA

03/22/2007

Question:

I was diagnosed in November 2006 with prostate cancer. My initial PSA was 7 in January 2006. In November it was 38.3. A subsequent biopsy disclosed two samples in 12 malignant, both in the same area and 30% of the sample. Gleason 3+4=7. My staging is T1C. A second PSA in December was 24 and after 30 days of Cipro, my PSA had dropped to 15. The biopsy also noted "focal acute and cronic inflammation". I am currently on Lupron (3 month) and will be starting Proton Beam Radiation in April. Is there any way to determine my real PSA as related to the adenocarcinoma?

Answer:

Not necessarily, several factors can influence the PSA, including cancer and inflammation. There is no good way to determine elevated PSA just as a result of cancer. Percent free PSA can help differentiate this some, but it is not perfect.

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Response by:

Lee E Ponsky, MD Lee E Ponsky, MD
Associate Professor of Urology
School of Medicine
Case Western Reserve University