Follow-up after treatment Prostate Cancer

Follow-up after treatment Prostate Cancer

Objectives of long-term followup is to continue the rehabilitation to monitor the success of treatment and to initiate timely further therapy with a possible progression of prostate cancer.
Among tumor aftercare refers to the long-term medical care of a cancer patient after a curative primary therapy, after initial treatment with healing intention. In prostate cancer, these are theradical prostatectomy and the (primary = initial) radiation . In another sense, one can also control the course during hormone therapy for cancer follow-count (see below). Unlike the control studies on deferred initial treatment, which were described earlier .

In addition to general care, for example by talking, is the main goal of cancer follow-up to monitor the success of treatment to prevent possible relapse (recurrence) of the tumor or metastases (secondary tumors) early detection. The aftercare may already during rehabilitation, begin the recovery phase immediately after the initial treatment. Conversely, sets the rehabilitation continues in the long follow-up, for example by further treatment of urinary incontinence (involuntary loss of urine) or erectile dysfunction (impaired limb stiffening), through aids in the mental area and assistance in health training, which includes proper nutrition.

Cancer follow-up after local curative therapy

According to the local (local) treatment by radical prostatectomy or radiation therapy are no symptoms (symptom) and the part of the tumor longer present, the follow-up examinations should be performed at the following intervals: the first 6-12 weeks after the end of treatment after the first in the two years, every 3 months, in the next two years, every 6 months, and from the fifth year every 12 months.

In each case, the intended PSA value can be determined. He rises above a certain limit to, one speaks of a biochemical recurrence (BCR). This may be caused by a recurrence of the tumor at the original site (tumor recurrence, "local recurrence") or the growth of metastases (secondary tumors) to lymph nodes or other parts of the body ("systemic relapse").

The DRE would indicate a recurrence later than the PSA level. It is therefore useful only for tumors that release no PSA. Imaging techniques such asMRI can be used for example for localization of tumor recurrence and metastasis. They should only be used when a local, targeted therapy is possible and / or symptoms persist.

The further diagnosis and treatment depend on the type of initial treatment, the location of the recurrence (local or systemic) and individual factors . For details in Sectionsradical prostatectomy and radiation therapy .

Follow-up during hormone therapy

During a prolonged hormone therapy every 3-6 months should have a physical examination performed and the PSA level can be determined. The use of other methods (eg, DRE = digital rectal examination, imaging, other laboratory tests such as the determination of testosteroneand other blood values) depends in turn on whether symptoms are present on the part of the tumor and whether it can have consequences for the treatment of the results .

These regular check-ups are necessary mainly in order to assess the response to hormonal therapy and to identify their possible adverse effects at an early stage and treat. It is important to determine the PSA nadir (lowest value). Rising PSA levels back up again, possibly, other medical measures possible