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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.