Cancer Prostate Cancer Diagnosis Prostate Cancer Recurrence By Matthew Schmitz, MD Matthew Schmitz, MD LinkedIn Matthew Schmitz, MD, is a professional radiologist who has worked extensively with prostate cancer patients and their families. Learn about our editorial process Updated on January 27, 2020 Medically reviewed by Doru Paul, MD Medically reviewed by Doru Paul, MD Doru Paul, MD, is triple board-certified in medical oncology, hematology, and internal medicine. He is an associate professor of clinical medicine at Weill Cornell Medical College and attending physician in the Department of Hematology and Oncology at the New York Presbyterian Weill Cornell Medical Center. Learn about our Medical Expert Board Print Recurrence of prostate cancer occurs when cancer returns after initial treatment has been completed. Prostate cancer can recur locally (in the area immediately surrounding the prostate) or distantly (anywhere else in the body). After surgery or radiation for prostate cancer that is confined to the prostate and nearby tissues, the prostate-specific antigen (PSA) levels usually go down to zero or nearly zero. The PSA level should stay stable at this very low level following treatment. George Doyle / Stockbyte / Getty Images The PSA level should be followed closely after initial treatment. If the PSA starts to rise again after it has gone down to zero or close to zero, this may signal that the prostate cancer has returned. It usually takes more than one elevated PSA test to determine that prostate cancer has returned. Because many things can contribute to an elevated PSA level, most healthcare providers want to see at least two consecutive increases in the PSA before they say that there is a good chance that prostate cancer has recurred. Who Is More Likely to Have Prostate Cancer Recurrence? In general, the further your cancer has spread and the more aggressive it is, the more likely it is to recur. Specific factors include: Tumor size: In general, the larger the tumor, the more likely it is to recur. Gleason score: A higher Gleason score means a more aggressive cancer and a higher rate of recurrence. Cancer staging: Staging refers to how far the cancer has spread. Higher stage cancers have spread further at initial treatment and have higher rates of recurrence. Involvement of the lymph nodes: Prostate cancer that has entered the lymph nodes prior to treatment is more likely to recur. What Can Be Done If your prostate cancer has recurred, your healthcare provider will likely order some imaging tests to better determine where in your body the cancer has returned. Bone scans, CT scans, and MRIs are the most common tests ordered to find where in the body prostate cancer has recurred. Many treatment options are available for prostate cancer that has returned. The one that you and your healthcare provider choose depends on individual factors such as what treatment you have already received, where in the body your prostate cancer has returned, how your cancer has spread, your general health, and your age. If your prostate cancer is thought to have recurred in only a small area and has not spread to other areas of the body, then radiation therapy to that area may be an option. If your prostate cancer has most likely spread to multiple areas of the body, then hormonal therapy would likely be an option. Chemotherapy can also be used when the cancer has spread to multiple sites. Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Geller J. Basis for Hormonal Management of Advanced Prostate Cancer. Cancer. 1993 Feb 1;71(3 Suppl):1039-45. Kupelian PA, Buchsbaum JC, Elshaikh M, et al. Factors Affecting Recurrence Rates After Prostatectomy or Radiotherapy in Localized Prostate Carcinoma Patients With Biopsy Gleason Score 8 or Above. Cancer. 2002 Dec 1;95(11):2302-7. Vickers AJ, Bianco FJ Jr, Boorjian S, et al. Does a Delay Between Diagnosis and Radical Prostatectomy Increase the Risk of Disease Recurrence? Cancer. 2006 Feb 1;106(3):576-80. By Matthew Schmitz, MD Matthew Schmitz, MD, is a professional radiologist who has worked extensively with prostate cancer patients and their families. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit