What to Ask When Your PSA Is Rising After Initial Treatment

For the majority of men, prostate cancer is treatable and curable and does not come back after initial treatment. However, about 25%–33% of men with prostate cancer will experience a recurrence of their cancer after surgery or radiation. Some of these men can still be cured with additional treatment, but some men develop a form of prostate cancer that, while not curable, remains TREATABLE for a very long time.

Below is a list of questions to ask when your PSA is rising after initial treatment.

• What does it mean that my PSA level is rising?
• What is my PSA level now, and how will we monitor changes over time?
• Can we (should we) chart the velocity or doubling time of my PSA? What can this tell us about my prognosis?
• Am I a candidate for local “salvage” prostatectomy or radiation? Why or why not?
• Should I get an imaging scan to see if the cancer has spread to my bones or other organs?
• If you recommend that I initiate androgen deprivation therapy (“hormone therapy”), how will this benefit me and slow down the growth of the cancer cells?
• When is the optimal time to initiate this treatment? For how long will I need it?
• What are the benefits and drawbacks/side effects of hormone therapy? Are there things that I can do to minimize the side effects?
• Should my treatment plan also include androgen receptor pathway inhibitor therapy or docetaxel?
• If the hormone therapy stops working, what treatment options remain?
• Are there dietary or other lifestyle changes that I could make to optimize my treatment?
• Should we add a medical oncologist to my treatment team to gain an additional perspective on treating my disease?
• Should I consider joining a clinical trial?