Radiation Therapy for Advanced or Recurrent Prostate Cancer

It has been estimated that 30% of men who are "cured" with initial treatment for early-stage prostate cancer will relapse after five years. For these men, as well as for those diagnosed with advanced-stage disease, some forms of radiation therapy might play a role in prostate cancer management.

For men who previously underwent prostatectomy, "salvage" external beam radiation can be delivered to the area immediately surrounding where the prostate was, in the hopes of eradicating any remaining prostate cells that have been left behind. Note that side effects from the radiation therapy can be moderately severe, and are additive to those previously received with surgery.

For men who previously underwent external beam radiation therapy, "salvage" brachytherapy, or radioactive seed implantation, can provide additional tumor control. Note that because this approach delivers radiation to very localized areas, it is not an optimal treatment for men with tumors that have spread beyond the prostate.

For all men, the best outcomes are seen in those men whose PSA levels are low and whose disease has not spread too far. Regular monitoring of PSA levels after primary therapy is key, as is prompt initiation of treatment upon disease recurrence. The earlier the treatment is begun, the better the likelihood of improved results.

External beam radiation therapy can also be used in men with painful bone metastases. A review of the treatment strategies for men with bone metastases can be found in the Managing Bone Metastases and Pain section.