Recurrent prostate cancer

Doctors often follow prostate cancer with PSA testing, examination and scans when needed. A detectable or rising PSA can lead to repeat testing and further assessment, but it does not by itself show where cancer is. Recurrence may be local, in nearby lymph nodes or distant, including bone.

Some people have no symptoms. Difficulty passing urine, blood in urine, back pain or hip pain may have causes other than cancer, yet new or persistent symptoms deserve medical review. The original tumour features, earlier treatment and the pace of PSA change help shape decisions.

Keep follow-up appointments and bring previous PSA results, treatment records and a current medicines list. Your team may recommend repeat PSA testing, imaging or biopsy. Treatment can include radiotherapy, hormone treatment, surgery, brachytherapy or targeted radioisotope therapy. Bone-strengthening therapy and pain support may be considered when cancer affects bones or bone health.

Ask how each option could affect urinary, bowel, sexual and bone health. A second opinion from a prostate cancer specialist can help when choices are complex.

Contact your care team promptly for worsening difficulty passing urine, visible blood in urine, persistent bone or back pain, leg weakness or numbness. Seek urgent help for inability to pass urine, sudden weakness, loss of bladder or bowel control or severe new pain. These symptoms need assessment whether or not recurrence has been confirmed.

What does my PSA pattern suggest, and should it be repeated? Do I need imaging or a biopsy? Is the suspected recurrence local or distant? Which treatment aims fit my goals, and how might each affect daily function? How will bone and urinary health be monitored?