PSA Nadir Level in Prostate Cancer

The Absolute Lowest Level the PSA Drops After Treatment

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The PSA nadir is the absolute lowest level that the PSA drops after treatment. PSA is a protein produced in the prostate. The PSA nadir can tell your practitioner a lot about how successful a given treatment has been, and can even give your healthcare provider an idea as to how likely you are to have recurrent prostate cancer.

Doctor reviewing medical chart with older man
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What Is Prostate Cancer?

Prostate cancer develops in the prostate—a small gland that makes seminal fluid. It is one of the most common types of cancer in men. Prostate cancer usually grows over time and in the beginning usually stays within the prostate gland, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly.


Prostate cancer that is more advanced may cause signs and symptoms such as:

  • Difficulty urinating
  • Decreased force in the stream of urine
  • Blood in the semen
  • Discomfort in the pelvic area
  • Bone pain
  • Erectile dysfunction

Risk Factors

Factors that can increase your risk of prostate cancer include:

  • Older age. Your risk of prostate cancer increases as you get older.
  • Race/Ethnicity. African Americans and Caribbean men of African descent have an increased risk of prostate cancer compared to men of other ethnic groups. In Black men, prostate cancer is also more likely to be aggressive or advanced.
  • Family history. If men in your family have had prostate cancer or breast cancer, your risk may be increased. 
  • Obesity. Obese men diagnosed with prostate cancer may be more likely to have advanced disease that's more difficult to treat.


Complications of prostate cancer and its treatments include:

  • Cancer that spreads (metastasizes). Prostate cancer can spread to nearby organs, or through your bloodstream or lymphatic system to your bones or other organs. 
  • Incontinence. Both prostate cancer and its treatment can cause urinary incontinence. Treatment options include medications, catheters, and surgery.
  • Erectile dysfunction. Erectile dysfunction can be a result of prostate cancer or its treatment, including surgery, radiation or hormone treatments. 


Prostate cancer treatment options depend on several things, from how fast the cancer is growing to how much it has spread. Treatments can include radiation therapy, hormone therapy, cryotherapy, chemotherapy, immunotherapy, and surgical removal of the prostate.

Radiation Therapy

Radiation therapy uses high-powered energy to kill cancer cells. Side effects can include painful urination, frequent urination, and urgent urination, as well as rectal symptoms, such as loose stools or pain when passing stools. Erectile dysfunction can also occur.

Hormone Therapy

Hormone therapy prevents your body from producing the male hormone testosterone. Testosterone helps prostate cancer cells multiply. Cutting off the supply of hormones may cause cancer cells to die or to grow more slowly.

Side effects of hormone therapy may include erectile dysfunction, hot flashes, loss of bone mass, reduced sex drive, and weight gain.

Freezing Prostate Tissue

Cryosurgery or cryoablation involves freezing tissue to kill cancer cells.


Chemotherapy uses drugs to kill rapidly growing cells, including cancer cells. Chemotherapy can be administered intravenously in your arm, in pill form or both.

Chemotherapy may be a treatment option for men with prostate cancer that has spread to distant areas of their bodies. Chemotherapy may also be an option for cancers that don't respond to hormone therapy.

Biological Therapy

Biological therapy, also called immunotherapy, uses your body's immune system to fight cancer cells. One type of biological therapy called sipuleucel-T (Provenge) has been developed to treat advanced, recurrent prostate cancer.

Surgery to Remove the Prostate

Surgery for prostate cancer involves removing the prostate gland (radical prostatectomy), some surrounding tissue and a few lymph nodes. 

Radical prostatectomy carries a risk of urinary incontinence and erectile dysfunction. 

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Cancer Society. Cancer facts for men.

  2. Prostate cancer: Introduction.

  3. Centers for Disease Control and Prevention. What are the symptoms of prostate cancer?

  4. Prostate Cancer Foundation. Prostate cancer risk factors.

  5. Prostate Cancer Foundation. Prostate cancer side effects.

  6. Mottet N, van den Bergh RCN, Briers E, et al. EAU-EANM-ESTRO-ESUR-SIOG Guidelines on prostate cancer-2020 update. Part 1: screening, diagnosis, and local treatment with curative intentEur Urol. 2021;79(2):243-262. doi:10.1016/j.eururo.2020.09.042

  7. Simoneau AR. Treatment- and disease-related complications of prostate cancerRev Urol. 2006;8 Suppl 2(Suppl 2):S56-S67.

  8. Haglind E, Carlsson S, Stranne J, et al. Urinary incontinence and erectile dysfunction after robotic versus open radical prostatectomy: A prospective, controlled, nonrandomised trialEur Urol. 2015;68(2):216-225. doi:10.1016/j.eururo.2015.02.029

By Matthew Schmitz, MD
Matthew Schmitz, MD, is a professional radiologist who has worked extensively with prostate cancer patients and their families.