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What You Need to Know About a Relapse of Prostate Cancer

When Prostate Cancer Comes Back: What You Need to Know

Prostate Cancer RelapseIf you’ve been treated for prostate cancer successfully in the past, recurrence of your cancer is probably your worst nightmare. But you should know that prostate cancer recurrence is far from a death sentence. Most men with prostate cancer don’t die of it — even when the cancer is recurrent.

Twenty to 30 percent of men who have been successfully treated for prostate cancer will experience a relapse more than five years after treatment, even if they have received a prostatectomy. But you don’t need to rush into aggressive treatment just because your cancer has come back. The speed with which your PSA levels return and the rate at which they rise will help your doctor determine whether you should pursue aggressive treatment, or adopt a wait-and-see approach.

Does Your Recurrent Prostate Cancer Warrant Aggressive Treatment?

Most men who experience a recurrence of prostate cancer don’t need aggressive treatment, say doctors at Johns Hopkins. While a recurrence of prostate cancer sounds scary, the most common types of this cancer are slow-growing. It’s not whether or not you have a recurrence of prostate cancer, but how quickly your PSA values double in the first two years after recurrence — a factor known as PSA doubling time — that determines whether or not you should get prostate cancer treatment again right away. Other factors doctors look at to assess your need for aggressive treatment include how soon your PSA levels return after treatment, and your Gleason score.

When Prostate Cancer Comes BackIf your PSA values return within three years of treatment, your doubling time is shorter than three months, and your Gleason score is eight or above, you’re considered highest-risk and you should consider pursuing aggressive treatment for your prostate cancer. The 15 year survival rates are low — less than one percent, so aggressive further treatment is the best option.

However, if your doubling time is longer than 15 months, your PSA values take longer than three years to return, and your Gleason score is lower than eight, you have a good chance of surviving even though your prostate cancer has returned. Men with these factors have a 94 percent rate of survival.

Coping with Prostate Cancer Recurrence

If your prostate cancer comes back, your doctor will decide, based on your specific situation, whether your cancer is aggressive and likely to spread or whether it is of the more common, slow-growing type. If you’re part of the majority of men whose recurrent prostate cancer is slow-growing, you and your doctor may decide to do nothing at first; it can be perfectly safe to wait and monitor prostate cancer, sometimes for years. Your doctor may recommend radiation therapy or chemotherapy to slow the growth of the cancer itself. Hormone therapy may help slow or stop the progression of your prostate cancer by blocking the mechanism of the male hormones that prostate cancer cells need to grow.

If you’re one of the 20 to 30 percent of men whose prostate cancer comes back after initially successful treatment, there’s good news — you still have a fairly good chance of survival. Your doctor will let you know what, if any, cancer treatment you need, so you can make the decision that’s best for you.