Life after treatment
For most people, the cancer experience doesn’t end on the last day of treatment. Life after cancer treatment can present its own challenges. You may have mixed feelings when treatment ends, and worry that every ache and pain means the cancer is coming back.
Some people say that they feel pressure to return to “normal life”. It is important to allow yourself time to adjust to the physical and emotional changes, and establish a new daily routine at your own pace. Your family and friends may also need time to adjust.
Cancer Council 13 11 20 can help you connect with other people who have had prostate cancer, and provide you with information about the emotional and practical aspects of living well after cancer.
For more on this, see Living well after cancer
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After treatment ends, you will have regular appointments to monitor your health, manage any long-term side effects, check that the cancer hasn’t come back, and discuss any concerns you have. During check-ups, you may have a physical examination, x-rays or scans, and a PSA test.
Depending on the type of treatment you had, PSA results will vary:
- After surgery, if it has been possible to remove all of the cancer, there should be no prostate cells left to make PSA antigen and your PSA level should drop quickly.
- After radiation therapy, your PSA level will drop gradually and it may take 2–3 years for your PSA to reach its lowest level.
- If you have androgen deprivation therapy (ADT) as well as radiation therapy, your PSA level will generally be very low while undergoing treatment.
The usefulness of the PSA test will vary. If you had localised prostate cancer, it can help find any cancer cells that come back. With advanced prostate cancer, particularly when the Gleason score or Grade Group is very high, the PSA test may be less useful.
Your doctor will also consider your symptoms and other test results along with the PSA test results. These all help to build a picture of what is happening to the cancer that is more accurate and informative than just the PSA test alone.
Talk to your doctor about how often you will need to have check-ups or a PSA test. Over time, if there are no further problems, your check-ups will become less frequent. If you notice any new symptoms between check-ups, you should let your GP or specialist know.
When a follow-up appointment or test is approaching, many people find that they think more about the cancer and may feel anxious. Talk to your treatment team or call Cancer Council 13 11 20 if you are finding it hard to manage this anxiety.
How you might feel
Being diagnosed with prostate cancer can be stressful. It is natural to have a wide variety of emotions after the diagnosis and during treatment, including anger, fear anxiety, sadness and resentment. These feelings may become stronger over time as you adjust to the physical side effects of treatment.
Everyone has their own ways of coping with their emotions. There is no right or wrong way. It is important to give yourself and those around you time to deal with the emotions that cancer can cause. For support, call Cancer Council 13 11 20.
If you have continued feelings of sadness, have trouble getting up in the morning or have lost motivation to do things that previously gave you pleasure, you may be experiencing depression. This is quite common among people who have had cancer.
If you think you may be depressed or feel that your emotions are affecting your day-to-day life, talk to your GP. Counselling or medication – even for a short time – may help. Some people can get a Medicare rebate for sessions with a psychologist. Cancer Council may also run a counselling program in your area.
Looking after yourself
Cancer can cause physical and emotional strain, so it’s important to look after your wellbeing. Cancer Council has free booklets and programs to help you during and after treatment.
Call 13 11 20 to find out more, or see Managing cancer side effects, Exercise after a cancer diagnosis, Complementary therapies, Emotions and cancer, Nutrition and cancer, Sexuality, intimacy and cancer, Fertility and cancer, and Living well after cancer.
Alternative therapies are therapies used instead of conventional medical treatments. These are unlikely to be scientifically tested, may prevent successful treatment of the cancer and can be harmful. Cancer Council does not recommend the use of alternative therapies as a cancer treatment.
If prostate cancer returns
Sometimes prostate cancer does come back after treatment, which is known as a recurrence. If your PSA level starts to rise and the cancer has not spread beyond the prostate, this may mean you still have cancer cells in the prostate area. If this happens, you may be monitored with regular blood tests or you may be offered further treatment, which is known as salvage treatment.
Your options will depend on the treatment you had. If you had surgery, you may be offered radiation therapy, and if you had radiation therapy, you may be offered further radiation therapy, surgery or other treatments. If the cancer has spread beyond the prostate, androgen deprivation therapy (ADT) is usually recommended and sometimes radiation therapy may be recommended. Surgery may be an option in some cases. You may be offered palliative treatment to manage symptoms.
It is possible for the cancer to come back in another part of your body. In this case, you may have treatment that focuses on the area where the cancer has returned. Talk to your doctors about the options. You can also call Cancer Council 13 11 20 for more information.
A/Prof Ian Vela, Urologic Oncologist, Princess Alexandra Hospital, Queensland University of Technology, and Urocology, QLD; A/Prof Arun Azad, Medical Oncologist, Urological Cancers, Peter MacCallum Cancer Centre, VIC; A/Prof Nicholas Brook, Consultant Urological Surgeon, Royal Adelaide Hospital and A/Prof Surgery, The University of Adelaide, SA; Peter Greaves, Consumer; Graham Henry, Consumer; Clin Prof Nat Lenzo, Nuclear Physician and Specialist in Internal Medicine, Group Clinical Director, GenesisCare Theranostics, and Notre Dame University Australia, WA; Henry McGregor, Men’s Health Physiotherapist, Adelaide Men’s Health Physio, SA; Jessica Medd, Senior Clinical Psychologist, Department of Urology, Concord Repatriation General Hospital, NSW; Dr Tom Shakespeare, Director, Radiation Oncology, Coffs Harbour, Port Macquarie and Lismore Public Hospitals, NSW; A/Prof David Smith, Senior Research Fellow, Daffodil Centre, Cancer Council NSW; Allison Turner, Prostate Cancer Specialist Nurse (PCFA), Canberra Region Cancer Centre, Canberra Hospital, ACT; Maria Veale, 13 11 20 Consultant, Cancer Council QLD; Michael Walkden, Consumer; Prof Scott Williams, Radiation Oncology Lead, Urology Tumour Stream, Peter MacCallum Cancer Centre, and Professor of Oncology, Sir Peter MacCallum Department of Oncology, The University of Melbourne, VIC.
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