Low PSA  - Aggressive Prostate Cancer

I recently met a man who was having difficulty understanding his advanced prostate cancer.

He was recently diagnosed with a PSA of 2.4 but he had a Gleason of 9 (5+4).  In addition, he had a positive bone scan.  What was confusing to him was how he could have aggressive cancer (Gleason 9) and such a low PSA.  

I explained that it isn't uncommon to have very aggressive advanced prostate cancer with a low PSA.  In some incidences, aggressive prostate cancer generates little PSA.  Someone once described it to me by saying that "it's as if the cancer just forgot how to make PSA." 

The take-home message for us is that we should never assume that because our PSA is low, our cancer is not aggressive.  Even with a low PSA, we need to know our Gleason score to help us to make the best possible treatment decisions.

Joel T. Nowak, MA, MSW wrote this Post.  Joel is the CEO/Executive Director of Cancer ABCs.  He is a Cancer Thriver diagnosed with five primary cancers - Thyroid, Metastatic Prostate, Renal, Melanoma, and the rare cancer Appendiceal cancer.