Table of Contents

Chapter 1: What Does a Diagnosis of Prostate Cancer Mean?

i. Where Does PSA Fit In?

PSA, or prostate-specific antigen, is a protein produced by the prostate and released in very small amounts into the bloodstream. When there’s a problem with the prostate, such as when prostate cancer develops and grows, more and more PSA is released, until it reaches a level where it can be easily detected in the blood. PSA plays two different roles in prostate cancer—first as a screening tool before the disease is diagnosed, and then as a way to monitor progression of the disease once it’s been established.

In this Guide, we’ll be focusing on the role of PSA as a marker for disease progression and as a way of determining whether a treatment is effectively doing its job. You might have been following the debates concerning the value of PSA in screening for prostate cancer. For you, this is no longer an issue. Now that you’ve been diagnosed with prostate cancer, you need to shift gears and focus on how to best treat your disease.

So how does your PSA fit in with your Gleason score?

The PSA level that you had before you were diagnosed with prostate cancer, known as your prediagnostic PSA, is often used as an indicator of how advanced your cancer was before it was detected. Usually, the higher the prediagnostic PSA, the more aggressive the disease, the same as with the Gleason grade.

Therefore, this PSA level, combined with your Gleason score, is typically used when trying to predict how your tumor will respond to different types of treatment, and how well you’re likely to fare following initial therapy. And, as we’ll see, having a general sense of what to expect can help you and your doctors figure out which treatment path is right for you.