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Initial treatment results

Guide 15. Tests used

Risk group

Test

How often is this test needed?

Very-low-, low-,

intermediate-, high-, and

very-high-risk cancers

treated for cure

Ü

PSA

Ü

• Every 6–12 months for 5 years

◦◦ If normal results, then PSA every year

Ü

DRE

Ü

• Every year unless PSA is undetectable

Very-high-risk, regional,

and metastatic cancers

not treated for cure

Ü

Physical exam

Ü

• Every 3–6 months

Ü

PSA

Ü

• Every 3–6 months

69

NCCN Guidelines for Patients

®

Prostate Cancer, Version 1.2016

6

Treatment guide: Monitoring

Initial treatment results

Guide 15

lists the tests used to assess the

results of initial treatment. For many men, the

goal of initial treatment is to cure the cancer.

A cure is possible when the cancer has not

spread far. The cancer may have been cured if

tests find no signs of cancer after treatment. An

undetectable PSA level after treatment is a good

sign. However, prostate cancer returns in some

men after having no signs of cancer for a period

of time.

DRE and PSA testing done on a regular basis

may catch a recurrence early. A DRE can find a

recurrence near the prostate. An increase in the

PSA level can be a sign of recurrence either near

the prostate or in other areas. Besides PSA level,

your doctor will assess the PSA doubling time and

velocity.

If the goal of your initial treatment was to cure

the cancer, PSA testing every 6 to 12 months for

5 years is recommended. However, PSA testing

every 3 months may be needed if you have a

high risk of recurrence. If PSA levels remain

normal during the 5 years, then PSA testing can

be done every year. A DRE can also help to find

a recurrence of prostate cancer early as well as

cancer in the rectum or colon.

If your initial treatment controls but doesn’t cure

the cancer, you should be checked often by a

doctor. In addition to PSA testing, a complete

physical exam is recommended. A physical exam

may tell if the cancer is still growing despite

undergoing treatment.