NCCN Guidelines for Patients® | Prostate Cancer - page 61

61
NCCN Guidelines for Patients
®
: Prostate Cancer
Version 1.2014
Part 6: Monitoring and salvage treatment
Par t 1
Par t 2
Par t 3
Par t 4
Par t 5
Par t 6
Par t 7
Par t 8
Par t 9
treat the metastatic site. However, observation may be a better choice depending on
your overall health and personal wishes.
Next steps
. Read Part 7 if 1) the cancer grows after either option for nonmetastatic
cancer; 2) you choose ADT to treat metastases; or 3) the cancer grows during
monitoring of metastatic cancer.
6.4 Treatment after radiation therapy
Test names
Cancer is found
in prostate but
hasn’t spread
Observation,
Test results
Cancer isn’t
found in prostate
or other areas
ADT,
Treatment options
Clinical trial, or
More testing
Observation,
Radical prostatectomy,
Cryosurgery, or
Brachytherapy
Able to
have local
treatment
Unable to have
local treatment
ADT, or
Monitoring
After radiation therapy, PSA levels usually fall to 0.3 ng/mL or below. If your PSA
increases by at least 2 ng/mL after falling to low levels, the cancer may have
returned. Signs of cancer also may be found by a DRE.
Local treatment is an option if: 1) the clinical stage was T1 or T2; 2) initial tests found
no lymph node metastases or weren’t done; 3) you’re likely to live at least another
Acronyms:
ADT
= Androgen
deprivation therapy
CAB
= Combined androgen
blockade
CT
= Computed
tomography
EBRT
= External beam
radiation therapy
LHRH
= Luteinizing
hormone-releasing hormone
MRI
= Magnetic resonance
imaging
PSA
= Prostate-specific
antigen
TRUS
= Transrectal
ultrasound
!
ReadPart 2 for testing
information andPart 4
for treatment details.
• PSA doubling time
• TRUS biopsy, and
• Bone scan
Possible tests:
• Abdominal and
pelvic CT or MRI
• Prostate MRI, or
• PET scan
ADT
Metastases
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