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Follow Up

What kind of follow up will I have?

The follow up for prostate cancer is relatively easy after seed implantation. The PSA is the most simple and reliable test to track your progress. We typically ask that the PSA be done at three month intervals for the first 2 years then every 6 months until the five year mark, and yearly thereafter. In addition, an occasional digital rectal exam is appropriate.

What is the PSA bounce?

After either external beam radiation or seed implantation, the PSA levels will decrease over time. The rate of the decrease is variable for patients and does not correlate to control of the cancer. Regardless of whether the PSA drops quickly or slowly, this does not predict for cancer control. One phenomenon, “the PSA bounce”, occurs in approximately 30% of the patients. This is seen as a rise in the PSA, often occurring 1-2 years after the implant or external beam radiation. We have often seen it occur even further out. The PSA rise typically can last for 3-6 months and then gradually decreases. The cause for this PSA bounce is unknown but it has been suspected to be caused by minor infection, a break down and dying of cells causing a mild inflammation or an effect on the vessels. It sometimes can be accompanied by symptoms of increased frequency, discomfort urinating or achiness in the prostate region. It is not necessary to treat it, however, we will often prescribe medications if the bounce is associated with symptoms.