After treatment, you will need regular check-ups to monitor your health and check that the prostate cancer hasn’t come back. This will involve testing your PSA level at regular intervals.
Your PSA level will vary depending on the type of treatment you had. After surgery, your PSA level should drop quickly to 0 (or to a level that can’t be detected), as there are no prostate cells left to make the antigen. After radiation therapy, your PSA level should drop gradually and it may take 2–3 years for your PSA to reach its lowest level. If you have ADT as well as radiation therapy, your PSA level will generally be quite low while undergoing treatment.
The PSA is only one test and it might not accurately reflect what is happening to the cancer. The PSA test can be useful with early prostate cancer, to help with diagnosis and monitor the need for treatment, or to detect the return of any cancer cells. With advanced prostate cancer, particularly when the Grade Group or Gleason score is very high, the PSA test becomes less useful.
Your doctor will also consider any symptoms you might or might not have, and the results of other blood tests and scans. These all help to build a picture of what is happening to the cancer that is more accurate and informative than just the PSA test alone.
Talk to your doctor about how often you will need check-ups or a PSA test. Over time, if there are no further problems, your checkups will become less frequent. If you notice any new symptoms in between check-ups, you should let your GP or specialist know.