PSA & Me

Blood Draw for PSA Test

You may have witnessed the dust-up in the news over PSA tests as an early-detection screen for prostate cancer. That’s not what I’m talking about here.

I’m talking about the role PSA plays in my life today and the role it’s played in my life in all the time since surgery, since hormone therapy, since radiation — since forever, it sometimes seems. The bottom line: PSA tests tell me how well I’m doing in my contest with cancer.


PSA stands for Prostate-Specific Antigen, a protein produced only by prostate cells. So when the prostate is removed at surgery, as mine was, PSA blood-test results should come back at roughly 0.00. No prostate gland, no PSA. Blood tests that do find PSA therefore mean that somewhere inside me there’s still some renegade prostate cancer. For now, any such cancer would be microscopic and not visible on any medical scan. Which is why we watch for PSA — it’s an early but dead give-away that prostate cancer’s recurred.

So, as I continue my cancer journey, here are the PSA trail markers that we’ll be on the lookout for:

Undetectable PSA. Things are under control, and any cancer that remains is insufficient to produce a measurable level of PSA. (They don’t say “zero” PSA because the test at my lab can measure, or detect, only 0.03 ng/mL and above.)

Detectable PSA. PSA has reached a level of 0.03 or greater. There’s still some cancer, but the lower the number, the better; and the longer it’s taken for PSA to come back, the better. A PSA level of 0.2 or more officially marks “recurrence” of cancer following a prostatectomy.

Rising PSA. Cancer is advancing. The slower the rate of increase, the better. Doubling-time is a common metric, and the longer it takes for PSA levels to double (starting at 0.2), the better.

My most recent test, in December 2021, came back at 0.26, essentially the same as the 0.27 of June 2021. We’ll test me for PSA again in six months (June 2022), and when my PSA reaches some trigger point…well, then we’ll move on to the next treatment. For now, though, we’ll just watch it to see how high, and how fast, it goes.

I’m not cured, I’m not in remission; I’m between treatments.


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