What happens after prostate cancer surgery?

After reading this article, you will know

• why you are examined regularly after the surgery
• what exactly is examined during follow-up care
• what a PSA value is
• what a high PSA value means after surgery
• what follow-up care consists of

Prostate cancer can often be treated effectively with surgery, which is a crucial step in your recovery. However, it’s not the end of your prostate cancer treatment. Your treatment team will continue to support you for many years after the surgery to ensure the treatment is successful and has improved your quality of life.

Prostate cancer surgery – why is aftercare important?

Surgery can help you live longer by removing prostate cancer. But in about 3 out of 10 men, the prostate cancer can recur. Your treatment team will check your blood PSA levels during each check-up. If they notice a rise in your PSA levels, it could be a sign that the cancer has returned. They will also do other tests if you have any symptoms. The tests will depend on where and what kind of symptoms you have.

Aftercare is not only about checking for cancer. Surgery can be hard on your body and sometimes causes lasting effects. Supportive therapies can also have many side effects. Your treatment team will watch for any symptoms and help you if needed. During these visits, you can talk about any problems you have – whether physical, psychological, or social.

What is a PSA value, and how high should it be?

PSA is a protein that is only made by the prostate. You can detect it in the blood with a special test. Prostate cancer cells make a lot of PSA, but a high PSA does not always mean cancer. It can also be from harmless changes in your body. You need more tests to be sure if you have cancer.

Even in healthy men, PSA levels vary a lot. However, the average level is less than 4 ng/mL (nanograms in one milliliter). After the prostate is removed with surgery, the blood’s PSA level becomes very low. It usually drops below 0.2 ng/mL.

What if your PSA level increases after the complete removal of the prostate?

If tests show that your PSA level is high again, your treatment team will likely repeat the test to confirm the result. If the value is confirmed, they will carry out different examinations. Depending on the circumstances, these may include palpation (physical examination with the fingers or thumb) of the area where the prostate was before surgery, a transrectal ultrasound, or a bone scan. These tests can show if and where the cancer is growing again.

If your healthcare team has confirmed that the cancer has returned, radiation therapy can often stop the tumor from growing further. If the cancer has already spread, your treatment team might offer you anti-hormone therapy or chemotherapy. The good news is that regular check-ups can catch cancer early before it spreads.

What happens after treatment?

Your treatment team will plan your check-ups based on your situation. How often you need to go to these check-ups will depend on what treatment you received previously. For example, if you were in a clinical trial for a new treatment, you might have to go to check-ups more often.

In summary

• Follow-up care for prostate cancer is done to detect if the cancer has returned.
• Your treatment team will monitor your side effects and support you with any problems you might have.

What you can do

• Talk openly about any problems related to your disease with your healthcare team.
• Eat well and try to avoid foods that may bother your bladder or digestive system.
• Drink lots of water and stay away from alcohol and tobacco.
• Get emotional support from your loved ones or other prostate cancer survivors.