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Radiation therapy following a recurrence of prostate cancer may reduce deaths specifically caused by the disease. These results were recently published in the Journal of the American Medical Association.

Prostate cancer is the most common cancer among American men. Often, men treated with initial therapy will experience a biochemical recurrence. This refers to an increase in prostate specific antigen (PSA) levels, which are small proteins shed into the blood by the prostate. Levels of PSA often indicate either the presence or recurrence of prostate cancer; therefore, follow-up after initial therapy includes PSA readings. PSA doubling time refers to the duration of time it takes for PSA levels to double; this measurement is often even more important than the absolute levels of PSA.

Researchers from Johns Hopkins University and Duke University recently reported that radiation therapy following a biochemical recurrence reduces deaths from prostate cancer among men with a PSA doubling time of less than six months. This study evaluated data from 635 patients who experienced a biochemical recurrence and/or a recurrence within the prostate following initial treatment with surgery. One group of patients had no subsequent therapy following a recurrence; one group received radiation therapy upon recurrence; and one group received radiation therapy and hormone therapy upon recurrence. Follow-up of the study was six years following a recurrence.

  • 22% of men who received no further therapy died from prostate cancer.
  • 11% of men who received radiation therapy died from prostate cancer.
  • 12% of men who received radiation therapy plus hormone therapy died from prostate cancer.
  • The increase in survival was limited to men with a PSA doubling-time of less than six months.
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The researchers concluded that radiation therapy upon a biochemical recurrence among men with prostate cancer who have undergone initial surgery appears to improve survival, specifically among men with a PSA doubling time of six months or less. Men who experience prostate cancer recurrences should speak with their physician regarding all of their treatment options. In addition, since this was an evaluation of data, the researchers stated that a clinical trial that directly compares different treatment options is necessary to determine the true clinical benefit of each type of therapy.

**Reference:**Trock BJ, Han M, Freedland SJ, et al. Prostate cancer-specific survival following salvage radiotherapy vs observation in men with biochemical recurrence after radical prostatectomy. Journal of the American Medical Association. 2008;299:2760-2769.

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