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Should a patient with elevated PSA levels undergo castration to overcome the risk of cancer metastasis?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

My PSA levels are increasing despite having had a prostatectomy two years ago. My PSA levels are doubling every six months. It is not yet at a serious level, but I think cancer has spread. Should I undergo castration to overcome this problem?

Thank you.

Hello,

Welcome to icliniq.com.

After surgery, PSA (prostate-specific antigen) levels above 0.1 ng per mL are considered high and need further evaluation with a PET (positron emission tomography) scan. If local reoccurrence occurs, radiation is the treatment option. If it is out of the prostate gland, the first treatment is castration, in which injections are given once every month or every three months. If you have any further questions, please let me know. If you can send me the current PSA level and testosterone radiology reports, that will be helpful.

Kind regards.

Patient's Query

Thank you doctor for the reply,

I have not had any radiation treatment yet. The specialist has suggested that cancer will not occur until my PSA level reaches 0.5 ng per mL. My latest blood test indicates a level of 0.19 ng per ml. My next blood test is programmed after a year. If I undergo a physical castration, will my problem be resolved? I want to stay alive.

Hello,

Welcome back to icliniq.com.

If your PSA (prostate-specific antigen) levels are 0.19 ng per mL, it is unlikely to metastasize. However, a PET (positron emission tomography) scan should be done before deciding on treatment. If local reoccurrence occurs, radiation therapy is the treatment. If metastasis is discovered, I suggest you undergo castration.

Kind regards.

Medically reviewed byiCliniq medical review team

Published At September 29, 2022
Reviewed AtJune 20, 2024

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