Recurrent Prostate Cancer Treatment

In some cases, prostate cancer recurs, or comes back, after a patient is treated with surgery or radiation. A rising PSA and/or a positive biopsy are the first indicators that the cancer has returned or has not been completely eradicated. We also offer PSMA PET imaging, an advanced technology that is the best available method for detecting prostate cancer anywhere in the body.

The multidisciplinary prostate cancer team at the University of Chicago Medicine specializes in the latest techniques for the treatment of cancer that has recurred.

Salvage Prostatectomy

Salvage radical prostatectomy refers to surgical removal of the prostate gland when cancer recurs after treatment. This procedure also includes the removal of adjoining seminal vesicles (glands that produce semen) and often the surrounding lymph nodes. Every attempt is made to spare the muscles and nerves important for preserving continence. This is a highly complex procedure with important considerations regarding quality-of-life but often is the only remaining curative option for men with recurrent prostate cancer. If you are considering a salvage prostatectomy, which is typically performed using a robot-assisted technique, it is important to have a detailed discussion with your surgeon.

Radiation Therapy

Radiation therapy can be effective for cancer that recurs after radical prostatectomy. Intensity-modulated radiation therapy (IMRT) can be used to target the tissues at risk for cancer recurrence, including the space that the prostate occupied before removal. In certain cases, radiation therapy is combined with hormonal therapy to improve the chance for cure.

Systemic Therapies

At UChicago Medicine, medical oncologists with special expertise in prostate cancer manage the treatment of men with recurrent disease. As members in the Prostate Cancer Clinical Trials Consortium (PCCTC), they collaborate with experts at more than 40 other research sites in the U.S. to design, implement and complete clinical trials of novel drugs for recurrent prostate cancer. As a result, our medical oncologists have access to the latest therapies for prostate cancer. And we continually research and develop new therapies for men with recurrent prostate cancer.

Systemic therapies — medications used to treat cancer by attacking it throughout the body — for recurrent prostate cancer include:

• Hormone Therapy: A treatment that removes or blocks the action of testosterone and other male hormones, which can cause prostate cancer to grow. Hormone therapy can involve medications, surgery or the use of other hormones to lower the amount of male hormones or prevent their action.
• Immunotherapy: Also called biologic therapy, immunotherapy uses the patient’s own immune system to boost and direct the body’s natural defenses to fight cancer.
• Lutetium-177 PSMA therapy (Pluvicto): UChicago Medicine was the first in Illinois to offer this advanced theranostic treatment that targets prostate cancer cells with lower side effects than many alternative treatments.