If you’ve gone through the difficult process of having surgery to remove your prostate after detection and treatment of cancer, it’s unlikely that the return of the disease is at the forefront of your mind. However, a small percentage of prostatectomy patients do, in fact, experience this very issue. 

Although it is rarely seen, prostate cancer recurrence after surgery is possible; current estimates suggest that it happens in either 4% or less than 10% of prostatectomy recipients. If it happens to you, or if you’re wondering if you’re at increased risk of developing such a postoperative reemergence of disease, then this patient guide may be able to help you decide what steps, if any, should be taken next. 

Read on in this patient guide from HIFU Prostate Services to learn more about prostate cancer recurrence, from the early signs and detection methods, to the available treatment options of addressing the cancer before it spreads or becomes more serious and difficult to manage. For more information about HIFU, or to find a treatment provider near you, please visit us online to get in touch today.

After Surgery To Remove The Prostate

Following a prostatectomy, the course of treatment generally follows a similar path for all patients, with variations and adjustments made as needed based on test results, physical response, and overall progression of recovery, from both a provider and patient perspective. Almost universally among post-operative men who have had a cancerous prostate removed, levels of PSA (prostate specific antigen) are expected to drop, and this decrease is seen in a measurable way that follows suit.

However, prostate cancer is not limited to the borders of the gland itself, and it is commonly found to metastasize in the tissues directly surrounding the prostate, or in the nearby seminal vesicles (internal reproductive structures, or sacs, used to store semen). If cancer spreads after a prostatectomy, it is likely going to be found in one or both of these areas. It can also cause the affected individual to exhibit elevated levels of PSA, which, as you’ll recall, should be steadily dropping or fully depleted after surgery has been completed.

How Prostate Cancer Recurrence Is Detected

Following surgery for prostate cancer removal, the majority of patients will have regular appointments to check in and assess recovery progress with their healthcare provider or preferred oncologist. At each of these visits, your doctor will draw blood to run tests on various levels of biomarkers, hormones, and immunological markers, including PSA. You may also undergo minor physical assessments as part of your post-prostatectomy preventive maintenance care plan.

If prostate specific antigen levels are found to be rising, staying the same as pre-operative quantities, or slowing their rate of decrease in an unexpected way, your provider may suggest imaging tests (CT, for example) or an X-ray of the prostate and pelvic area. A few other alternative options for detecting prostate cancer recurrence are available, although some are in the early stages of development or are not yet widely available, so should not be used as a default or go-to option for determining whether metastatic resurgence is a clear and present health risk.

 

Are you a practicing healthcare provider or oncologist who would like to learn more about alternative options for localized detection of recurrent prostate cancer? 

Check out the full infographic here.

 

I’ve Had A Prostatectomy. Am I At Risk Of Cancer Returning?

Although all forms of cancer are technically a cellular mutation that cannot necessarily be prevented or controlled, there are factors that may increase the risk of prostate cancer recurrence, even after surgery. These include, but are not limited to, the following:

• Stage of Prostate Cancer 
  • If the prostate cancer was detected in a later stage, or if cancerous tissue or tumor growth is significantly progressed, a prostatectomy may be slightly less effective for the purposes of controlling future susceptibility to recurrence.
• Gleason Score
  • This bio-ranking provides a grade of how far a given case of prostate cancer has or has not progressed. The higher the Gleason score, the more advanced the disease; a lower score, understandably, is indicative of early-stage cancer. In essence, the Gleason score value a patient has at the time of a prostatectomy procedure is positively correlated with the likelihood of the cancer coming back.
• Tumor Size
  • Like the other factors mentioned, the size of the tumor on the prostate at the time of its surgical removal can be related to a given patient’s risk of recurrence.
• Lymph Node Health
  • Some men with prostate cancer may also develop cancer cells in the pelvic region’s lymph nodes, and subsequently are at a higher risk of cancer returning after radiotherapy and/or surgery.

What Treatment Options Are Best For Recurrent Prostate Cancer?

The most suitable treatment for prostate cancer, if it becomes an issue once again after a prostatectomy, will vary on a patient-by-patient basis. These differences are usually contingent on a combination of factors, including the increased risk markers (discussed above), the area of the body where recurrence manifests, the age of the patient, personal medical history, and more.

In many cases, hormone treatment may be recommended and carried out. This option for addressing recurrent prostate cancer works by blocking the cellular and physiological effects of certain male hormones. This kind of mitigation may further be supplemented with specialized drugs that play a significant role in preventing metastatic processes and curbing the cancer’s rate of growth.

Other options that can effectively eradicate or adequately address prostate cancer recurrence include high-intensity focused ultrasound (HIFU), radiation therapies, and certain drug-based or chemotherapeutic approaches.

Final Thoughts: Preventive Maintenance Is Always A Good Idea

Prostate cancer is never an easy diagnosis to receive, and if you’ve already endured the physical and mental toll of a prostatectomy surgery, you certainly would like to hope it has been effective in its removal of the diseased tissue. However, approximately one-twentieth of men who undergo this procedure may not be completely free of the cancer. 

If you or a loved one has reason to believe that prostate cancer recurrence is at play, or an increased risk of onset is likely, please contact HIFU Prostate Services today to discuss your options for noninvasive treatment. For more patient guides, healthcare resources, and medical news updates, please feel free to explore all of our articles on the official HIFU blog.