Local failure of Prostate Cancer can occur after surgery, external beam radiation or seed implantation. The initial indication that this may have occurred is the slow rise of PSA.  Diagnostic imaging prior to this point did not particularly improve the ability of physicians to identify focal areas of the prostate that may harbor recurrent cancer.  Therefore seed implant or radiation failure patients were treated in the past with either surgery or offered hormonal therapy at some point when the PSA rose to a higher level. typically around 10 ng/ml. This were not always the ideal approach.

However there is new hope for patients with recurrent disease that will allow for minimally invasive treatment without the use of hormonal therapy or extensive radical surgery . We (Drs Grimm and Hsi) are currently developing and using techniques, such as multiparametric MRI imaging, mapping techniques and sophisticated planning systems ( Brachysurgery)  Combined with therapies to improve the ability to identify localized (Focal) recurrence and treat with either Cryotherapy or focal Brachytherapy/Brachysurgery to small areas of the prostate harboring recurrent disease. We began this effort as a pilot program  as now have established early results and protocols . Initial responses have been very good.

 If you have a rising PSA after either external radiation (IMRT, Protons, Cyberknife) you may wish to inquire about our on-going protocols regarding these treatments.