A few months after a prostatectomy, the PSA level should be undetectable or very low, explains the American Cancer Society. The first PSA test should be taken no earlier than six to eight weeks after surgery because the protein takes time to clear out of the blood.
The presence of any PSA after surgery is often a cause of concern for patients because rising PSA levels can mean prostate cancer recurrence, according to the American Cancer Society. Cancer is not always the cause, however, and PSA levels that are very low, steady and not rising can be produced by normal, leftover prostate tissue, says the Prostate Cancer Foundation.
When the protein is detectable after surgery, doctors frequently measure PSA levels a few times to determine if they are increasing, according to the Prostate Cancer Foundation. Cancer recurrence is considered to be indicated by a PSA level that is greater than 0.2 nanogram per milliliter that has risen at least twice in an interval of two or more weeks. When this occurs, doctors often proceed to salvage radiation therapy. This procedure is frequently performed with external beam radiation and aims to destroy the remaining prostate cancer cells.
Another treatment option for recurrence is androgen deprivation therapy, which stops the production and action of testosterone on prostate cancer cells, explains the Prostate Cancer Foundation. Testosterone is a hormone that stimulates prostate growth and the growth of prostate cancer cells. When the hormone is no longer available, or its action is blocked, the cancer stops growing. Not all cancer cells are hormone sensitive, and this treatment is typically not a cure.