In the months and years following treatment, your doctor will monitor you for any signs that your prostate cancer has returned, sometimes known as a surveillance plan.
Specifically, your doctor will be on the lookout for the onset of new symptoms such as difficulties with urinating, bone pain, a rise in your post-treatment prostate specific antigen (PSA) levels (which should be essentially zero after definitive treatment), new abnormalities on the digital rectal examination (DRE) or other parts of the physical exam, and abnormal growths seen on imaging exams such as a CT scan.
Unfortunately, there is no set-in-stone standard of care that all physicians agree upon for how surveillance follow-up testing should be done for initially-treated prostate cancer. Some important organizations such as the National Comprehensive Cancer Network (NCCN) have published their own guidelines, however, and many physicians agree with these.
Just as with all other aspects of prostate cancer, your personal health and preferences play a huge role in deciding how to go about monitoring for disease recurrence.
If you and your doctor decide that your other health conditions are so serious that prostate cancer is not a top priority, then your schedule of follow-up testing will likely be very different from someone who is otherwise healthy, and has a great deal of incentive to catch any recurrence as early as possible. That’s why it’s so important to go over your concerns with your physician before deciding on a surveillance plan.
Evans, CP. Follow-up surveillance strategies for genitourinary malignancies. Cancer 2002; 94:2892.
National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines available online at www.nccn.org/physician_gls/f_guidelines.html.