What are signs of prostate cancer recurrence
By Dr. David Samadi
Completing treatment for prostate cancer often brings a mix of emotions—relief from having finished treatment and concern about the possibility of the cancer returning. Early detection and treatment can lead to remission, with many men living cancer-free for years, or even the rest of their lives. Yet, it’s natural to feel anxious or fearful about the chance of recurrence.
What is Cancer Recurrence?
Cancer recurrence happens when cancer returns after a period during which it was undetectable in the body. It’s important to understand that while recurrence is a valid concern, it shouldn’t dominate your life. Although recurrence isn’t something you can control, how you manage the fear of it is within your power.
The good news is that nearly all men with localized prostate cancer have a five-year survival rate of almost 100%. However, recurrence affects up to 40% of men, so understanding your personal risk is crucial.
PSA Monitoring and Biochemical Recurrence
After prostate cancer treatment, one key indicator of your progress is your PSA (prostate-specific antigen) levels. Regular PSA tests help your healthcare team assess how well the treatment is working. A significant drop in PSA is a positive sign, but if it begins to rise again, this could indicate a biochemical recurrence—a sign that some cancer cells have survived and are producing PSA.
If this occurs, your doctor may order additional tests and suggest a new management plan. Just as at the time of your initial diagnosis, it’s important to consider all your options, possibly seeking a second opinion or care from a multidisciplinary team. Biochemical recurrence does not always mean immediate treatment is necessary, and your doctor will take into account multiple factors, including your initial cancer’s characteristics, PSA doubling time, prior treatments, and your overall health.
What Increases the Risk of Recurrence?
Many men worry about prostate cancer recurrence after completing initial treatment. While advancements in therapies have significantly improved outcomes, understanding your specific risk factors can help keep you informed.
Several factors influence recurrence risk, such as:
- The cancer’s initial stage and grade
- Type of treatment received (surgery, radiation, hormone therapy)
- Your Gleason score and PSA levels before and after treatment
- Age and general health
Men with higher-risk prostate cancer (such as advanced-stage disease, high Gleason score, or elevated PSA levels) are more likely to face a recurrence. However, individual risks vary, so your healthcare provider can offer a more personalized perspective.
Signs of Prostate Cancer Recurrence
Some men may experience a prostate cancer recurrence without noticeable symptoms, especially in cases of biochemical recurrence, where only PSA levels rise. However, others may develop more apparent symptoms, including:
1. Elevated PSA Levels
A steady increase in PSA after treatment can be an early sign of recurrence. Your doctor will monitor PSA levels regularly to assess recurrence risk.
2. Urinary Issues
Recurrence may cause difficulty with urination, a weak urine stream, increased urgency, or pain during urination.
3. Bone Pain
If prostate cancer spreads, it may affect bones, leading to persistent pain in the back, hips, or pelvis.
4. Fatigue
Recurrence can result in unexplained fatigue, reduced energy, or weakness that doesn’t improve with rest.
5. Unintentional Weight Loss
Losing weight without changes to diet or exercise habits can be concerning and should be addressed with your doctor.
Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board-certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy. Dr. Samadi is a medical contributor to NewsMax TV and is also the author of two books, Prostate Cancer, Now What? A Practical Guide to Diagnosis, Treatment, and Recovery, and The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.