A PSA of 0.05 ng/mL after prostate removal generally indicates a very successful surgery, often considered "undetectable," but requires ongoing monitoring as it's slightly above the ideal <0.02 level and could suggest microscopic residual cells, though not always cancerous, with doctors typically watching for a sustained rise above 0.2 ng/mL as a sign of biochemical relapse (cancer recurrence).
Your prostate cancer can come back: within the prostate gland if you haven't had surgery to remove your prostate. in the area where the prostate was, if you have had surgery to remove your prostate. in the area just outside the prostate.
Prostate-specific antigen (PSA) testing is recommended every 6 to 12 months for the first 5 years following radical prostatectomy as a means to detect potential disease recurrence.
Biochemical recurrence refers to a rise in the blood level of PSA (prostate-specific antigen) in prostate cancer patients after treatment with surgery or radiation. It may mean that the cancer has come back. Also called biochemical relapse and PSA failure.
That answer to that question is straightforward for men who undergo radical prostatectomy: in the weeks after surgery, the PSA should become undetectable, falling to less than 0.1.
Only the prostate gland releases PSA, so your numbers should drop to almost zero within 4 weeks after your surgery. A test result above 0.2 ng/mL a few months after your procedure could be a sign that your prostate cancer has come back.
The PSA level should go down significantly after treatment for prostate cancer. It usually drops to a very low or undetectable level within 2 months after a radical prostatectomy. But the PSA level usually drops more slowly after radiation therapy, taking from 6 months to a few years to reach its lowest level.
Depending on the laboratory used, this may be recorded as values less than < 0.2 ng/mL, <0.1 ng/mL, <0.05 ng/mL, <0.01 ng/mL or < 0.008 ng/mL. For patients treated with surgery, biochemical recurrence is typically defined as a PSA level of at least 0.2 ng/mL. Sometimes, an increased PSA level may be a false result.
In other words, most recurrences happen within 5 years after surgery. After 10 years, the risk of a PSA recurrence becomes very low–but it's still possible, and this is why many urologists advise their patients to keep getting the PSA checked for decades.
PSA levels are used to monitor prostate health and detect potential issues. Expected PSA Levels After Surgery: Following a radical prostatectomy (complete removal of the prostate), PSA levels should drop to undetectable levels, typically less than 0.1 ng/mL.
You are likely to have problems controlling your bladder after a radical prostatectomy. Being unable to control when you pee and leaking urine is called incontinence. You might also need to pass urine more often than usual, and it might be harder to hold it in.
Life expectancy after prostate removal (radical prostatectomy) is generally very positive, with studies showing high survival rates (over 90% at 10 years for localized cancer) and many men living 10 to 20+ years, often longer than the general population due to early detection and treatment advances, though outcomes depend on cancer stage, tumor aggressiveness, and overall health.
Previous studies from the authors' institution and other institutions have demonstrated nadir PSA ranging from 0.9 to 1.9 ng/dl at 3 to 6 months post-HoLEP. Another study noted 6-month PSA levels of 1.0±0.3 ng/dl irrespective of the use of holmium or thulium laser or monopolar energy for endoscopic enucleation.
Conclusions: On average, we found a man undergoing radical prostatectomy for localized prostate cancer can expect about a 1 in 4 chance of biochemical recurrence. Of men with BCR, we identified a 1 in 10 chance of developing metastases, surviving nearly 9 years after incident metastasis.
Signs and symptoms of prostate cancer recurrence
Even if your cancer was treated with an initial primary therapy (surgery or radiation), there is always a possibility that the cancer will reoccur. About 20 percent to-30 percent of men will relapse (have the cancer detected by a PSA blood test) after the five-year mark, following the initial therapy.
After surgery, the main source of PSA, the prostate, is removed and within 4-6 weeks the PSA is expected to fall to very low levels (less than 0.1) and often to an undetectable level. After radiation therapy, PSA levels will drop steadily and may take 18 months or more to reach the lowest level (the nadir).
If someone has a prostate enlargement at 50 years weighing more than 50 grams, he might have the potential for the prostate to regrow even after surgery and this propensity increases with larger prostates of more than 80-90 grams, as they tend to recur with age mostly five to ten years later.
Most people feel that they are getting back to normal activities between 4 to 6 weeks after surgery. You should not undertake strenuous activities for 6 weeks.
PSA increases with age, and your PSA should be compared with normal values for men in your age group. For example, the average PSA for younger men (aged 40–49) ranges from 0.5–0.7 ng/mL, and men with a PSA above the median are at higher risk of later developing prostate cancer.
If the prostate has been removed (understand that PSA stands for a prostate-specific antigen, meaning it is only made by prostate cells), a detectable PSA means that prostate cells are present somewhere in the body.
Definition of undetectable ultrasensitive prostate-specific antigen. The definition of undetectable USPSA for this analysis was ≤0.05 ng/ml. PSA data in the UODB come from multiple laboratories that define undetectable PSA levels at either ≤0.02 ng/ml or ≤0.05 ng/ml.
After any enlarged prostate procedure, a number of factors can cause PSA levels to go up again, including:
Nearly all men will experience some erectile dysfunction for the first few months after prostate cancer treatment. However, within one year after treatment, nearly all men with intact nerves will see a substantial improvement.
Because the risk of recurrence is so low after 20 years of undetectable PSA, and because it takes an average of eight years after PSA reappears before metastasis to develop, “we suggest that PSA testing can be stopped at 20 years for men with an undetectable PSA and intermediate or high-risk prostate cancer,” Walsh ...