How to Determine Prostate Cancer Recurrence

According to the American Cancer Society, prostate cancer is the second-leading cause of cancer death in American men. Incidence of this type of cancer is about one-third higher for black men than for white men. Rates of prostate cancer rose dramatically (108 percent) among all men in the late 1980s, when the prostate specific antigen (PSA) screening test was introduced. By the early 1990s, rates of prostate cancer in all men began to decline.

Instructions

• 1

  Regular monitoring of the prostate specific antigen (PSA) through blood testing after initial treatment provides the best indication that the cancer may have recurred. After either surgery or radiation treatment for prostate cancer, the PSA levels should reduce to nearly zero and remain very low. If PSA levels start to rise again after treatment, it could mean the cancer has returned.

• 2

  Because many factors can influence the PSA level, most physicians require at least two consecutive tests that show a rise in PSA levels before diagnosing a cancer recurrence. Federal guidelines recommend checkups six weeks after initial treatment, then at three, six, nine and 12 months. For those with recurrent cancer, follow-up care is based on individual symptoms, prognosis and type of treatment.

• 3

  Prostate cancer can reappear in the prostate or elsewhere in the body. Tumor size, stage of the cancer and involvement of the lymph nodes affect whether the cancer is aggressive and has spread. The bigger the tumor, the greater the chance that it may have spread to other areas of the body. Prostate cancer that spreads to the lymph nodes before initial treatment has a greater likelihood of recurrence. Determination of cancer spread is also measured by staging; higher stages at first treatment have a greater chance of recurrence.

• 4

  Once your doctor is convinced the cancer has returned, he will likely order imaging tests to determine where in your body the cancer is located. These tests may include bone scans, magnetic resonance imaging (MRI) or computerized axial tomography (CT) scans.

• 5

  In some cases, your doctor may perform needle biopsy on those specific sites where cancer is suspected. If the cancer is confined to a small area and has not spread, targeted radiation therapy may be used for treatment. If the cancer has spread to several locations in the body, hormonal or chemotherapy may be advised.