Can I stop PSA testing 10 years after radical prostatectomy?

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 ...

clinicalconnection.hopkinsmedicine.org - When Can PSA Testing Be Stopped After Prostatectomy?

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Discovery

December 1, 2017

You’ve done it for so long, and thank goodness, it has always come back undetectable. Sometimes you wonder if maybe you could stop taking the yearly PSA test; but then again, you’ve read that cancer can come back many years after a prostatectomy. Is it ever safe to stop PSA testing?

Yes! Reassuring evidence from Brady studies provides some guidelines. Several years ago, urologist Stacy Loeb, M.D., now on the faculty at New York University, examined Hopkins prostatectomy patients who had an undetectable PSA at 10 years after surgery. With further follow-up, she reported that recurrence was very rare for men with low-grade (Gleason 3 + 3) disease, and not a single man developed metastatic disease after 10 years. She suggested that men with low-grade disease could reasonably stop testing if their PSA levels remained undetectable for 10 years. But what about men with intermediateor high-risk disease? There remains “no standard practice regarding when PSA testing can be stopped for these men who have an undetectable PSA level over longer periods of time,” says Patrick C. Walsh, M.D., University Distinguished Service Professor of Urology. Walsh was senior investigator in a new study that looked at long-term PSA levels of more than 700 Brady prostatectomy patients whose PSA levels have remained undetectable for 20 or more years of follow-up. The other investigators include Wesley Ludwig, M.D., biostatistician Zhaoyong Feng, Bruce Trock, Ph.D., and Elizabeth Humphreys. Ludwig, Brady resident and the study’s lead author, notes that of the men with intermediate- and high-risk disease, a very small number (2.3 percent) developed prostate cancer recurrence, only a single patient developed metastatic disease, and none died of prostate cancer. “We found that the majority of men who had detectable PSA developed it within two years of their radical prostatectomy, and the likelihood decreased every five years,” Ludwig reports. Previously, Brady investigators have shown that the likelihood of having PSA return after 15 years is only 1.5 percent. The men most likely to have a delayed return of PSA were those who had an elevated PSA at the time of radical prostatectomy, higher clinical and pathologic stage, and positive surgical margins. The good news is that even with a return of PSA, these men have excellent chances of survival. With the longer follow-up period in this study, the investigators were able to analyze risk from 20 to 30 years. 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 says.

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Is Turkey good for your prostate?

Animal fat has been linked to an increased risk for prostate cancer, so to minimize those risks, choose lean meats like chicken, turkey, or fish. Fish is rich in omega-3 fatty acids, which are known to reduce your risk for prostate cancer.

myhealthkc.com - Foods That Support Prostate Health | MyHealthKC

Since prostate cancer is one of the most common cancers in men and about half of all men experience prostate issues after age 50, it’s a good idea to eat foods that support prostate health.

Berries

High in vitamin C and antioxidants, berries protect the body from free radicals, molecules that attack healthy cells and contribute to cancer risk. Throw some fresh or frozen blueberries and strawberries in your protein shake for a healthy post-workout snack.

Lean meat and fish

Flaxseed

If you don’t like fish, flaxseed is an alternative way to get omega-3s in your diet. You can incorporate flaxseed into baked goods or your favorite smoothie recipe.

Beans & seeds

Beans, chia, and hemp seeds pack a ton of protein and nutrients, which make them great meat replacers when you are avoiding fatty red meat.

Green tea

Green tea not only lowers cholesterol; it’s also been linked to protecting against prostate cancer. Try brewing some green tea for a mid-morning boost instead of reaching for another cup of coffee. All of these fruits are refreshing in the warmer months and have also been found to prevent prostate cancer. This is due to a chemical compound called lycopene, known as one of the most powerful antioxidants in the world. For more resources and advice on men’s health, check out the top health concerns for men at every age and The Men’s Guide to Living Healthy from AdventHealth.

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