Local therapy for prostate-specific antigen recurrence after definitive treatment

Abstract

Disease recurrence after local therapy for prostate cancer is increasingly common, most often with detectable or rising prostate-specific antigen (PSA) the earliest sign. Analysis of clinical and pathological factors can help determine which patients are at risk for treatment failure, while PSA characteristics and imaging studies can localize site of recurrent disease and identify men who may benefit from salvage therapy. Local treatment options include radiation therapy (external beam and brachytherapy) and cryoablation for patients who have undergone prostatectomy, and surgery, brachytherapy, and cryoablation for patients who have received radiotherapy. Novel treatment modalities are under investigation and may improve success of local salvage therapy while minimizing morbidity.