Follow-up after treatment for prostate cancer
Prostate cancer behaves differently in each man, and a standard follow-up schedule would not work for everyone. Men with prostate cancer should talk to their doctor about a follow-up plan that suits their individual situation. Follow-up care is often shared among the cancer specialists and the family doctor.
After treatment has ended, new symptoms and symptoms that don't go away should be reported to the doctor without waiting for the next scheduled appointment. These may include:
- changes in bladder habits
- need to urinate often (frequency), especially at night
- intense need to urinate (urgency)
- difficulty in starting or stopping the urine flow
- inability to urinate
- bone pain, especially in the back, hips, thighs or neck
- loss of sensation or muscle strength in the legs
- loss of bladder control or bowel function
The chance of prostate cancer recurring is greatest within 5 years, so close follow-up is needed during this time.
Follow-up after prostate cancer treatment varies depending on what type of treatment the man received.
Follow-up visits after a radical prostatectomy are usually scheduled:
- shortly after surgery
- every 3 or 6 months for 1 to 2 years
- then once a year
Follow-up visits after radiation therapy are usually scheduled:
- 6 months after radiation therapy has finished
- every 6 months for 1 to 2 years
- then once a year
During a follow-up visit, the doctor usually asks questions about the side effects of treatment and how the man is coping. The doctor may do a complete physical examination, including a digital rectal examination (DRE) if the prostate-specific antigen (PSA) level has increased.
Tests may be ordered as part of follow-up or if the doctor suspects the cancer has come back (has recurred).
- PSA test
- This is the primary follow-up blood test for prostate cancer.
- The lowest level that the PSA reaches (called the nadir) is recorded and used as a baseline for future PSA tests.
- If the PSA level rises over time (known as biochemical failure), more tests will be done.
- After radiation therapy, there may be a temporary rise in the PSA level (called a PSA bounce).
- testosteronetestosteroneA male sex hormone that causes male sex characteristics to develop (such as deep voice and facial hair) and stimulates the development of the male reproductive system and sexual activity. level
- This test may be done when a man is on hormonal therapy and his PSA level is rising.
- It ensures that the hormonal therapy is working to lower the amount of testosterone in the body to the castrate level. (The castrate level is the level of testosterone that would be present if a man's testicles were removed.)
- bone scan
- This may be ordered if the PSA level is rising.
If a recurrence is found during follow-up, the oncology team will assess the man with cancer to determine the best treatment options.