- With Mayo Clinic urologist
Erik Castle, M.D.
read biographyclose windowBiography of
Erik Castle, M.D.
Erik Castle, M.D.
Dr. Erik Castle is a board-certified urologist who joined the Mayo Clinic staff in Arizona in 2007.
Dr. Castle is an associate professor of urology at College of Medicine, Mayo Clinic, and a senior associate consultant in the Department of Urology, where he also is assistant residency coordinator.
He was an assistant professor in the Department of Urology at Tulane University in New Orleans from 2004 to 2006 after serving as a clinical instructor/fellow at Mayo Clinic in Arizona for one year.
Dr. Castle's research interests include prostate cancer, bladder cancer and kidney cancer. He is the director of the Desert Mountain Prostate Cancer Research Fund and is the principal investigator of Castle labs housed at the Samuel C. Johnson Medical Research building at Mayo Clinic in Arizona. His basic science research is focused on novel secondary hormonal therapies of prostate cancer as well as genomics of prostate and bladder cancer.
His surgical expertise includes laparoscopic urology, robot-assisted radical prostatectomy with nerve sparing, robot-assisted radical cystectomy with neobladder, robot-assisted retroperitoneal lymph node dissection, robot-assisted partial nephrectomy and other robotic urologic oncology procedures. He has performed many of these procedures as demonstrations internationally. He is a member of the American Association of Clinical Urologists, the American Urological Association, the Endourological Society, and the Society of Laparoendoscopic Surgeons. He is president of the international Society of Urologic Robotic Surgeons. He is also the director of the international laparoscopic nephrectomy courses throughout Mexico on behalf of the American Urologic Association.
More answers
- Prostate cancer brachytherapy: Can I pass radiation to others?
- Vasectomy: Does it increase my risk of prostate cancer?
- Prostate cancer vaccine: Is it available?
- Watchful waiting and prostate cancer: What does it mean?
- Pomegranate juice: A cure for prostate cancer?
- Prostate cancer: Can it spread to the pancreas?
- Prostate cancer treatment: Is prostatectomy possible if brachytherapy fails?
- Frequent sex: Does it protect against prostate cancer?
- Flaxseed: Does it increase my prostate cancer risk?
- see all
Mayo Clinic Health Manager
Get free personalized health guidance for you and your family.
Get Started
Mayo Clinic Housecall
Stay up to date on the latest health information.
What you get
- Free weekly e-newsletter
- Mayo Clinic expertise
- Recipes, tools and other helpful information
- We do not share your e-mail address
Question
Prostate cancer: Does PSA level affect prognosis?
I read an article that said that prostate cancer may grow slowly because PSA keeps it in check. So, men with higher PSA levels have a better prognosis for prostate cancer than do men with lower PSA levels. Can you explain this?
Answer
from Erik Castle, M.D.
Prostate-specific antigen (PSA) is a protein made by your prostate tissue. Men with prostate cancer often have elevated PSA levels because the cancer cells make excessive amounts of this protein.
At the time of your initial diagnosis of prostate cancer, your PSA level helps determine how likely it is that your cancer has spread (metastasized). It also determines how likely your cancer will be cured with treatment such as radiation or surgery. Generally, the higher your PSA level and the higher the speed at which it increases, the more prostate cancer cells you have in your body.
But this isn't always the case. In some cases, the PSA level may not be elevated, despite the prostate cancer. These cancer cells often have more genetic mutations than other cancer cells do, and they don't have the ability to make PSA. This type of prostate cancer is usually more aggressive and doesn't respond well to treatment. Some scientists believe that genetic mutations in these cancer cells may allow such cancers to grow and spread more quickly.
Prostate cancer often grows very slowly. The reasons for this aren't clear. Some research suggests that PSA may inhibit the formation of new blood vessels (angiogenesis) that contribute to the growth of cancer. This could explain why prostate cancers that don't produce PSA tend to grow and spread more rapidly than prostate cancers that do produce PSA. Still, you shouldn't immediately interpret a high PSA level to be protective against prostate cancer. You should discuss the results of your PSA test with your doctor before doing further tests or treatments.
Research on PSA levels and prostate cancer is ongoing. If you're concerned about your prostate cancer risk, ask your doctor what additional tests might benefit you.
Next question
