NCCN Guidelines for Patients
Prostate Cancer, Version 1.2016
Treatment guide: Monitoring
Treatment after prostatectomy
For known or highly suspected distant metastases,
ADT is the main treatment. Radiation therapy may
also be used to treat the metastatic site. However,
observation may be a better choice depending on
your overall health and personal wishes.
After treatment, testing to monitor treatment results
will start again. These tests include PSA with either a
DRE or physical exam. If the tests suggest the cancer
is growing or spreading, imaging tests are advised.
Imaging tests should include a chest x-ray, bone
scan, and CT or MRI of your abdomen and pelvis. CT
and MRI can be done with or without contrast.
A PET scan may also be helpful. For prostate cancer,
a radiotracer called C-11 choline will first be injected
into your body. The radiotracer is detected with a
special camera during the scan. Prostate cancer
cells appear brighter in images than normal cells
because they use a lot of choline to quickly build their
membrane. Thus, PET can show even small amounts
of cancer. However, it is unclear 1) if such PET scans
improve outcomes in this setting, and 2) how results
should be used for decisions about health care.