Most men can hold off on radiation after prostate cancer surgery

Decisions about follow-up care after prostate cancer surgery sometimes involve a basic choice. If the cancer had features that predict it could return, doctors will likely recommend radiation therapy. But when should a man get that treatment? Should he get the radiation right away, even if there’s no evidence of cancer in the body (this is called adjuvant radiation)? Or should he opt for “salvage” radiation, which is given only if his blood levels of prostate-specific antigen (PSA) begin to climb? Since prostate cancer cells release PSA, the levels should be nondetectable after surgery. If they increase, that means the cancer has begun to metastasize, or spread. Now preliminary findings from a European clinical trial show that for many men, waiting can be a safe bet. Called the RADICALS-RT trial, this is the largest study yet of adjuvant versus salvage radiation for prostate cancer. In all, nearly 4,000 men have been enrolled, all of them with features that predict an intermediate or high risk of recurrence, such as aggressive cancer cells in the tumor, pre-operative PSA levels in excess of 10 nanograms per deciliter, or positive surgical margins (residual cancer cells in the tissues surrounding the area where the prostate used to be). One group of men received adjuvant radiation while their PSA was undetectable, and the other group got salvage radiation if PSA levels spiked by at least 0.1 ng/dL during two consecutive measurements. Similar outcomes Five-year data are n...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Living With Prostate Cancer Treatments HPK Source Type: blogs