Can Prostate Cancer Come Back After Treatment?

Even after treatment and recovery, it is possible to get prostate cancer again. When cancer comes back, it is called a recurrence. Here is what you need to know about cancer returning.

Understanding recurrence

When tackling issues of prostate cancer recurrence, you should first have a clear understanding of the following terms:^1,2

• Recurrence – This means cancer was undetected for a time after treatment but your doctor has found it again. It may have come back in the same area as before or spread to another part of your body.
• Controlled prostate cancer – You have cancer, but it is not changing. Your doctor may also call it “stable.”
• Castrate-resistant prostate cancer (CRPC) – This cancer keeps developing even when the testosterone levels are at or below the castrate level.
• Hormone-refractory prostate cancer (HRPC) – HRPC means cancer has progressed beyond the use of all hormone therapies.
• Second cancer – Here, a second type of cancer, separate from the original type, is discovered.

How do I know if treatment worked?

Most commonly, doctors monitor prostate-specific antigen (PSA) levels in your blood. If treatment has worked, there will often be lower levels of PSA in your blood. Higher PSA levels might be a sign of cancer, though PSA levels can fluctuate without a cancer diagnosis.³

PSA levels typically drop to lower levels and become stable after radiation therapy for prostate cancer. PSA levels will also become virtually undetectable when you have surgery to remove your prostate. Your doctor will use PSA levels in combination of other tests to see if your treatment has worked.³

What are the recurrence rates for prostate cancer?

Around 20 to 30 percent of men with prostate cancer will face the disease again within 5 years of treatment. Some studies have explored whether recurrence rates vary widely by treatment, such as surgery or radiation therapy, but have found no major differences. There is no way to know for sure whether cancer will return or spread. Doctors look at things like how aggressive the cancer is and its extent to figure out your chances of recurrence.⁴

Doctors diagnose most prostate cancers in the early stages, which means a better long-term survival rate. Five years after diagnosis, a man with prostate cancer has the same survival rate as a man without the illness.

Prevention tips

Your doctor will recommend follow-up appointments and tests to check your PSA levels within a few months of treatment.⁵

Your cancer care team may also create a survivorship plan that includes a schedule of follow-up visits, a list of side effects and symptoms to look out for, physical activities, and diet suggestions.⁵

They could also recommend a lifestyle changes such as:⁵

• Quitting smoking
• Keeping your weight in check
• Maintaining a healthy diet
• Regular exercise
• Mental and emotional support

Researchers are also studying how some medicines can stop cancer from returning. A study published in 2022 looked at the connection between the use of beta-blockers after prostate cancer surgery (prostatectomy) and cancer recurrence.⁶

Researchers have found that after surgery, the body releases certain hormones like adrenaline in response to physical and emotional stress. These hormones may play a role in the growth and spread of cancer cells. Men who took beta-blockers at the time of surgery to ward off the effects of adrenaline had a lower chance of cancer coming back or spreading. More research is needed to understand the link. Do not start a new drug without first talking to your doctor about whether it is right for you.⁶