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Prostate Cancer

Why Radiation When the Location of Cancer is Unknown?

04/20/2007

Question:

I have had RP with a recurrance 4 yrs later. PSA has been .2 for 12 months now. Bone scan, prostacint, biopsy and CT scan show no hot spots. The doctor says they don`t know where the cancer is but will take a guess and radiate the bed of where the prostate was. My cancer had gone out of the capsule at the time of RP. This doesn`t seem right to me. Why radiate me at all right now? He says after .5 there`s no point in radiation. Why can`t they see the cancer?

Answer:

The PSA test is an excellent way to follow the disease.  If the tumor had extended beyond the prostate the chances of recurrence rises and this is the value of PSA in that it can detect recurrence very early.  Radiation therapy is commonly used in this situation and the evidence indicates that it is most effective when PSA is low because this indicates that tumor volume is also low.  I would suggest going with the recommendations of your physician.

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Response by:

Martin I Resnick, MD Martin I Resnick, MD
Formerly, Professor of Urology
School of Medicine
Case Western Reserve University