Recurrent prostate cancer
Recurrent prostate cancer means the cancer has come back despite treatment.
If prostate specific antigen or PSA levels begin to rise at any time after treatment, this may indicate a recurrence of the cancer and additional tests may be arranged.
How common is recurrence of prostate cancer?
Office for National Statistics data show that the five-year relative survival rate (an estimate of the probability of survival from the cancer alone) for adults in England diagnosed with prostate cancer between 2001 and 2006, and followed up to 2007, was 77%. Since many of the men who get prostate cancer are already elderly, they are more likely to die from other causes than from the cancer itself.
More than 90% of the time prostate cancer is discovered while it is either confined to the prostate gland or has spread beyond the prostate to only a small degree - referred to as regional spread.
Among the fewer than 10% of men whose prostate cancers have already spread to distant parts of the body at the time of diagnosis, about 34% are expected to survive for at least five years.
How is a recurrence detected?
After prostate cancer treatment you will go for medical check-ups every few months as determined by your doctor. At each follow-up appointment your doctor will arrange a blood test to measure PSA levels. This test helps your doctor to detect any cancer recurrence.
When PSA test results suggest that the cancer has come back or continued to spread, X-rays or other imaging tests (such as a bone scan) may be performed, depending on your situation and symptoms.
What factors determine the likelihood of recurrence?
Several signs can point to a prostate cancer that has returned or spread including:
- Men who have cancer cells in the lymph nodes of their pelvic region may be more likely to have a recurrence.
- In general the larger the tumour, the greater the chance of recurrence.
- The higher the grade, the greater the chance of recurrence. Your doctor can tell you your score when the biopsy results come back from the laboratory.
- The stage of a cancer is one of the most important factors in selecting treatment options as well as in predicting the future outlook for the cancer.
What type of follow-up treatments are recommended?
If prostate cancer recurs, follow-up treatment depends on what treatment you have already had, the extent of your cancer, the site of recurrence, other illnesses, your age and other aspects of your medical circumstances.
One possible treatment may be hormone therapy. Researchers are working on new drugs to block the effects of male hormones that can cause prostate cancer to grow, as well as on drugs to prevent prostate cancer growth.
Radiotherapy or medicines may be given to relieve symptoms of bone pain. Chemotherapy or other treatments in clinical trials are also options.
There are currently several types of vaccines in development for boosting the body's immune system against prostate cancer cells. One of these, called sipuleucel-T, is currently available to treat men with prostate cancer.