MONITORING
Monitoring normally includes:
- A PSA test and DRE once or twice a year.
- Watching for symptoms of disease, such as anemia, fatigue, weight loss, and bladder function problems.
It may also include a post-void residual test (checks the bladder's ability to empty), a bone scan, and/or cat scan.
About the post-void residual test
About bone scans
About cat scans (computerized axial tomography)
RECURRENCE
Prostate cancer can return, even if you no longer have a prostate. However, if there is no sign of a recurrence within ten years, it is extremely unlikely to occur. If it does, you may still be able to get rid of it with other procedures (see Salvage, below).
About recurrence
Recurrent prostate cancer
Treatment of recurrent prostate cancer
When cancer recurs
Work-up and treatment of recurring prostate cancerBiochemical failure. Recurrence is usually detected by "biochemical failure," a gradual rise in PSA. The PSA is then tested more frequently to discover how fast it is rising.
About biochemical failure
About PSA
PSA anxiety. Even three consecutive rises in PSA do not necessarily mean the cancer is back. Some PSAs go beyond the official failure level and some even go very high without consequences. Recurrence is not necessarily a death sentence, and it is possible that it may not even reduce your quality of life. Don't panic. PSA anxiety is one thing that always reduces quality of life.
About PSA Anxiety
Advanced Cancer (a section of this guide)
Facing Forward, A Guide for Survivors
SALVAGE
If your PSA suggests a recurrence at some point following treatment, you will have to discuss salvage techniques with your doctors. If the prostate is still present, a radical prostatectomy may be attempted. Organs cannot handle more than a certain total dose of radiation over the course of a lifetime, but some limited form of radiation may be possible nevertheless. If salvage is not possible, you will probably have to begin hormone-blockade therapy.
Recurrent prostate cancer: treatment and salvage
About hormone-blockade therapy (a section of this guide)
Cryotherapy as salvage therapy
Seeds as salvage following radiation
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