After a radical prostatectomy (open or robot-assisted), a man’s PSA level should fall to almost zero since the entire prostate has been removed. If this does not happen, however, it is likely a sign of recurrent cancer. Tests may be done to determine if the cancer has spread to other areas of the body. A bone scan shows if cancer has spread to the bones, and a CT scan or MRI can indicate the spread of the cancer to the lymph nodes or to other organs. In some cases, radiation therapy may be prescribed as part of the ongoing treatment plan.
Salvage Treatment After Primary Radiation Treatment
After radiotherapy, PSA levels normally fall to 0.3 ng/mL or below. If the PSA increases to at least 2 ng/mL after falling to low levels, it may indicate that the cancer has returned. Signs of cancer may also be found by a digital rectal exam (DRE). To confirm if salvage therapy is the correct treatment, additional tests may be needed.
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