Prostate-specific antigen (PSA) persistence or recurrence
PSA persistence or recurrence may occur after you've been treated for localized prostate cancer. Usually the level of PSA in the blood drops very low after radiation therapy or surgery to remove the prostate. But this doesn't always happen.
- Sometimes, the PSA level doesn't drop as much as expected. This is called PSA persistence.
- Sometimes after falling very low, the PSA level starts rising. This is called PSA recurrence.
If your PSA level persists or rises after treatment, you may have tests to see if the cancer is still there, has come back (recurrence), or has spread to other parts of your body (metastasis). You may need treatment, even if the cancer hasn't spread. Or you may be able to delay treatment until tests show that you are likely to develop symptoms. Treatment is based on what kind of treatment you had before.
How do doctors treat a PSA level that persists or rises after prostate cancer treatment?
Treatment for PSA persistence or recurrence is based on what type of treatment you had before and whether the cancer has spread (metastasis). If you aren't having symptoms, treatment may be delayed until tests show that you are likely to develop symptoms.
If you had surgery (radical prostatectomy), treatment options may include:
- Radiation therapy. This is often given by a machine outside the body (external radiation). It may also be given by placing substances inside the body (internal radiation).
- Hormone therapy. This may be given alone or with other treatments, such as radiation therapy.
- Chemotherapy.
- Immunotherapy. One type is a cancer vaccine.
- Observation.
If you had radiation therapy, treatment options may include:
- Observation.
- Hormone therapy.
- Surgery to remove the prostate (radical prostatectomy) and nearby lymph nodes.
- Cryosurgery.
- High-intensity focused ultrasound (HIFU).
- Radiation therapy.
- Other medicines, such as immunotherapy.
Your doctor will talk with you about your options and then make a treatment plan.
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