What is so special about PSA 2?

Hi Agent99 - the reason is that you have had the nuclear blast of radiotherapy through your prostate and so that’s why PSA is 0.07.  Whilst you still have a gland, it is not the same gland as before radiotherapy (won’t produce fluid, for instance).  Think of it as a nuclear wasteland of scar tissue, which used to contain active cancer cells (now dead, as they had their DNA twisted by the radiotherapy so were killed off when they tried to duplicate).  You’re left with prostate cells still alive and they can still grow and will produce much smaller amounts of PSA in this wasteland of a (non functional) gland. The level of 2.0 is set, because if it’s higher than that, it will be coming from elsewhere, other than the gland. A 2.0 would start the diagnosis again, with -ideally - a PSMA PET scan to see where in the body the PSA is coming from (ie where the escaped prostate cancer cells have managed to hide and grow, outside the gland).   AW

Great explanation AW & one that makes perfect sense to me.

Now why can't medical pamphlets etc be written in such a clear understandable way, perhaps with a medical explanation alongside to cater for the technically minded? 

I was looking at the internet (I know) and came across some interesting info about rising PSA levels

The most common reason is the PSA is being produced by prostate cancer cells somewhere else in the body. These cells may have been dormant for a period of time before beginning to produce a level of PSA detectable on a blood test.

Also something I never knew before about PSA -  Its primary role prevents semen from clotting so that sperm can “swim” freely. 

Good question and one I had not thought to ask!  We, also, are living post ht and rt and knowing that 2 is definitely not the magic number for us also! Thanks, too, to Aw, for the answer!!!

I hasten to add that PSA can be raised to a relatively low level by prostate  cancer escapees elsewhere in the body: the 2.0 figure is set because the medics feel that anything lower then that is unlikely to show up on a full body scan to find it.  However, the PSMA PET scan is a game changer, and if I had a rising PSA below 2.0 (say, at around the 1.0-1.5 mark) I would be pushing for a PSMA PET scan to try to identify the cancer location earlier before it can spread further.  With NHS policy, this would probably mean thinking about using private medical facilities. Just hope it doesn’t come to that !   AW

Hi Agent99 - re the sperm swimming freely! When my husband was considering a vasectomy many years ago, his GP mentioned a potential link with vasectomy and prostate cancer. I have never heard or read this elsewhere but, as the number of cases of PC seems to be on a big rise I’m wondering whether this has been investigated? Of course, we are an ageing population and people are far more aware of PC so there are bound to be more cases but I still wonder……

Oh Worriedwife 

I never thought about that but I will ask at our next oncology visit in September . Hope all is well 

best wishes & hugs 

Liz & OH xx

Back in January 2019 these people did a study of over 2 million Danish men and found a distinct link between vasectomy and prostate cancer.

https://pubmed.ncbi.nlm.nih.gov/31119294/

To save you reading the whole thing, their conclusion was:

"Vasectomy is associated with a statistically significantly increased long-term risk of prostate cancer. The absolute increased risk following vasectomy is nevertheless small, but our finding supports a relationship between reproductive factors and prostate cancer risk."

On a personal level, I'm sure they're right - I'm living proof.

I first had cancer back in 2022 but I had a vasectomy......back in 1989 when I was 34.  See - proof even though there's a mere 33 years between the dates!!

I had heard about that potential link a few years back too. When I was considering a vasectomy, I asked my GP and she said she had never heard of it. Just goes to show what a variance there is across the country.

In the end, I didn’t have the vasectomy, but still got PC. The way the dice fall can be strange!