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Does Cancer Creep Back After Prostatectomy?

Posted by guyrm @guyrm, Mar 30 8:19am

After reading these discussion boards (thanks for sharing guys!), it sounds like some men find themselves dealing with a return of cancer after what seems like a successful prostatectomy? I am 7 years out and hadn't really thought about a return of the cancer elsewhere.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

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manutebol | @manutebol | Apr 3 11:43am
In reply to @melvinw "Yes, it happens, even many years later, and I am one example of that. RARP in..." + (show)
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Yes, it happens, even many years later, and I am one example of that.

RARP in 2015. Pathology showed Gleason 3+4 with one positive margin. My Prolaris score also projected a 53% chance of a BCR at ten years.

I went ten years, getting regular PSA tests and DREs. PSA stayed below detection (< 0.1), and like you, I never thought much about it or fretted over it. In 2024, my urologist detected a small, palpable nodule in my prostate bed during a DRE, but my PSA was still undetectable. No action at that point.

In June 2025, my PSA rose to 0.11. PSMA PET and pelvic MRI scans confirmed that the nodule was cancerous, but there was no evidence of spread beyond that nodule.

In fall 2025, I underwent salvage radiation therapy (38 sessions of IMRT). My PSA at the start of radiation (ultra sensitive test) was 0.094. Effectively no change in the three months since June.

So far, so good. No lingering side effects from the RT. My first post-RT PSA test came back at 0.086 (again, ultra sensitive test). Likely that my PSA will continue to drop as the cancer cells die off (the radiation damages their DNA, so they die when the attempt to divide).

The odds of a recurrence after 3-5 years post-RARP go down significantly, but there are guys that have recurrences 20 years later. Also, the longer the time to relapse, the more likely the cancer is slow growing.

The best thing you can do for yourself is to keep up with your PSA tests…forever.

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@melvinw Did you have any ultrasensitive PSA tests done after your surgery in 2015, or were they all done with the < 0.1 threshold? I’m curious of the path of your PSA since you took so long to recur. Thanks.

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manutebol | @manutebol | Apr 3 11:54am
In reply to @jeffmarc "@jeff1963 I am disappointed that the mammogram doesn’t take into account genetic problems. Not completely useful." + (show)
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@jeff1963
I am disappointed that the mammogram doesn’t take into account genetic problems.

Not completely useful.

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@jeffmarc Mammogram! I see what you did there!

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Jeff Marchi | @jeffmarc | Apr 3 12:18pm
In reply to @manutebol "@jeffmarc Mammogram! I see what you did there!" + (show)
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@jeffmarc Mammogram! I see what you did there!

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@manutebol
Frustrating spellchecker. I use voice recognition and said nomogram, It showed up properly when I looked at it, but later the spellcheck changed it to mammogram. Unfortunately, I noticed it too late and was unable to edit the original statement. Maybe this will clear it up.

I’m sure a few people got a laugh about that.

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melvinw | @melvinw | Apr 3 12:51pm
In reply to @manutebol "@melvinw Did you have any ultrasensitive PSA tests done after your surgery in 2015, or were..." + (show)
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@melvinw Did you have any ultrasensitive PSA tests done after your surgery in 2015, or were they all done with the < 0.1 threshold? I’m curious of the path of your PSA since you took so long to recur. Thanks.

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@manutebol All my post-RARP PSA tests were standard tests, done with the < 0.1 threshold for detection. My first ultra sensitive PSA test was a few days before I started radiation treatment. I will be doing the ultra sensitive test from here forward.

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thomasmichael | @thomasmichael | Apr 4 9:28pm

I also had the surgery 7 years ago. Same progression as yours. I don’t believe in a cure. The docs just put it to sleep. Who knows when it’s gonna wake up? Keep getting those PSA’s!

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firespooks | @firespooks | Apr 5 4:33am

My thoughts exactly, Thomas !

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VancouverIslandHiker | @vancouverislandhiker | Apr 6 6:25am
In reply to @jeffmarc "I know people with Gleason nine that had it return after 30 years following a prostatectomy...." + (show)
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I know people with Gleason nine that had it return after 30 years following a prostatectomy. Some have it return after 10 or 20 years. One reason is, Even before the cancer is detected, dormant cells proliferate through the body. Some stressful event occurs they can re-awaken and become active cancer.

Here’s an article about it
https://www.dropbox.com/scl/fi/8wyq61jnnxl9g9cbmek5g/Dormant-cancer-cell-details.html

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@jeffmarc yes , good point Jeff . Mine started to rise to 0.18 , I decided with my team to put "pedal to the metal " and go early for 22 sessions- NO ADT, of External Beam Radiation ( EBRT) . It knocked it back to 0.066 and seems to be going sideways on every 6 month PSA tests . Drs say non cancerous 'normal' cells will push PSA in background like this almost forever . They will usually not be killed with radiation, only cancerous cells . Also moving from 6 months from 3 months make some kind of nervous . Hmmm I wonder if my team is right ? Hope you're doing well . J

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