What are the options for managing a recurrence of cancer?
A ‘biochemical recurrence’ of prostate cancer is defined by an elevated PSA. The major challenge when this occurs is to determine the site of the disease recurrence. Research by the Smilow Center has shown that imaging studies such as MRIs, bone scans and ProstaScint scans rarely identify the site of recurrence (Lepor H, Perlmutter MA. Urol. 71(3):501-5 (2008)). If the disease recurrence is localized (confined to the area of the prostatic bed), then salvage radiotherapy is likely to cure the disease. On the other hand, if the recurrence is due to systemic disease, salvage radiotherapy will fail, and hormonal therapy may be offered. The likelihood that salvage radiotherapy will be effective depends on a host of factors (Stephenson AJ et al. JAMA. 291(11):1325-32 (2004); Patel R, Lepor H, Thiel RP, Taneja SS. Urol. 65(5): 942-6 (2005)).
