Do Men With Prostate Cancer Who Undergo Surgery Need Radiation Therapy, Too?

There are a number of treatment options for men with prostate cancer. These include a surgical procedure, known as radical prostatectomy, as well as radiation therapy (hereafter referred to as RT). Are there any situations wherein a man who undergoes a radical prostatectomy will need RT afterwards?

The answer is yes, in special circumstances. Such RT is known as salvage radiotherapy, and is advisable for men whose PSA levels rise after surgery, as well as for those whose PSA levels never fully decline. The reason is that this additional treatment can increase the odds of survival for such men.

A recent study reviewed the data of 635 men with rising PSA levels after radical prostatectomy. In the study, 160 of the men received salvage RT, 78 received salvage RT and hormonal therapy (which lowers the level of prostate cancer stimulating male hormones in the blood stream), and 397 received no treatment.

Over the ensuing ten years, of the men who received salvage RT alone or salvage RT plus hormonal therapy, the rate of death from prostate cancer was nearly 60% less than that of the men who were not treated.

Salvage RT is noted to be most beneficial for men with rising PSA levels when it is administered promptly after the problem is identified. In contrast, if men with climbing PSA levels defer RT more than two years after the initial PSA spike, no benefit is noted.

Additional analysis revealed that the beneficial effect of salvage RT was confined to those men whose PSA levels doubled in less than six months, suggesting that a rapid PSA doubling time is indicative of more aggressive disease.

Therefore, the good news is that for men whose PSA levels climb after radical prostatectomy, RT can be life saving