Prostate cancer that is no longer confined to the prostate gland needs to be treated with systemic treatments that affect your entire body, not just the targeted or localized area that primary treatment is designed to accomplish.
Exceptions would be:
* You still have your prostate gland after non-surgical primary treatment such as radiation or received seeds (Brachytherapy), cryosurgery or HIFU (High Intensity Focused Ultrasound), and the subsequent PSA rise is due only to lingering cancer cells that remain active in your prostate gland. Here additional focused treatment to the gland itself may help.
* Or, you may have some prostate cancer cells remaining in the area close to where the gland had been prior to surgery. It is possible to treat these “hot spots” with external beam radiation and halt the cancer’s progress.
I no longer think of my prostate cancer as curable, but as chronic…something I can fight until I am in my nineties and maybe, even, my hundreds
Treating Reoccurring Prostate Cancer
Reoccurring prostate cancer, when caught early after primary treatment, is sometimes treatable with another locally focused procedure, such as radiation or cryotherapy, but it must be caught very early in its progression, in cases of failed surgery prior to the PSA making it to 1.0. This second, locally focused treatment is often called “salvage therapy.”
After your treatment, always remain vigilant in monitoring your PSA so you could catch a reoccurrence very early.
If the primary treatment you had was surgery, and your PSA begins to rise, or if the PSA fails to become undetectable following surgery, beginning radiation salvage therapy and hormone therapy may still beat the cancer and provide you with a good outlook. If the primary treatment was radiation, surgery or focal surgery may beat the cancer.
If you find yourself in this position, it is best to identify where the cancer is located in order to develop an optimum treatment plan. Scans are the best way to accomplish this. In addition to glucose-based PET scans, one other FDA-approved method, a PET scan using c11 Choline PE, is available only at the Mayo Clinic in Rochester, Minnesota. Unlike glucose, Choline is rapidly taken up by prostate cells so Choline-based scans will indicate a significant metabolic uptake in areas where the cancer has spread. Unfortunately, these scans also have a high rate of false positives, so confirmatory tests should be performed. (To learn more about Choline-based PET scans go to the advanced prostate cancer blog at: