 Introduction/Background Prostate cancer is primarily managed by 4 standard treatment methods: radical prostatectomy (RP), radiation therapy (RT), androgen deprivation therapy (ADT), and active surveillance (AS). A detailed discussion of relatively new focal therapies, such as cryotherapy, high-intensity focused ultrasound (US), and MRI-guided ablative techniques are beyond the scope of this document. The treatment choice is based on the tumor stage, histology, and grade and is influenced to a certain extent by the preference of the treating physician and the patient. After treatment, patients are followed at periodic intervals with the measurement of serum prostate- specific antigen (PSA) levels. RP and RT, which includes brachytherapy, are considered definitive treatment therapies. Biochemical recurrence (BCR), also referred to as PSA recurrence, PSA failure, or biochemical failure, is the most clinically used endpoint for identification of treatment failure. A number of clinical nomograms are available to predict BCR, time to metastasis, and prostate cancer-specific mortality [1-3]. Approximately 10% to 53% of patients undergoing primary intended curative therapy will develop BCR, depending on their preoperative disease risk and stage of cancer [4]. For localized low-risk prostate cancer, the rate of BCR is as low as 9% after RP [2,4]. A first serum total PSA assay is recommended during the first 3 to 12 months after RP or RT. When PSA is detectable following RP, a PSA assay should be repeated 1 to 3 months later to confirm this elevation and to estimate the PSA doubling time (PSADT). In the absence of residual or recurrent cancer, PSA becomes undetectable by the first month after total prostatectomy (<0.1 ng/mL) [5]. No imaging study is necessary after definitive treatment for clinically localized prostate cancer before BCR unless there are concerns for complications such as a fistula or abscess [6].
Post Treatment Follow up of Prostate Cancer.  Introduction/Background Prostate cancer is primarily managed by 4 standard treatment methods: radical prostatectomy (RP), radiation therapy (RT), androgen deprivation therapy (ADT), and active surveillance (AS). A detailed discussion of relatively new focal therapies, such as cryotherapy, high-intensity focused ultrasound (US), and MRI-guided ablative techniques are beyond the scope of this document. The treatment choice is based on the tumor stage, histology, and grade and is influenced to a certain extent by the preference of the treating physician and the patient. After treatment, patients are followed at periodic intervals with the measurement of serum prostate- specific antigen (PSA) levels. RP and RT, which includes brachytherapy, are considered definitive treatment therapies. Biochemical recurrence (BCR), also referred to as PSA recurrence, PSA failure, or biochemical failure, is the most clinically used endpoint for identification of treatment failure. A number of clinical nomograms are available to predict BCR, time to metastasis, and prostate cancer-specific mortality [1-3]. Approximately 10% to 53% of patients undergoing primary intended curative therapy will develop BCR, depending on their preoperative disease risk and stage of cancer [4]. For localized low-risk prostate cancer, the rate of BCR is as low as 9% after RP [2,4]. A first serum total PSA assay is recommended during the first 3 to 12 months after RP or RT. When PSA is detectable following RP, a PSA assay should be repeated 1 to 3 months later to confirm this elevation and to estimate the PSA doubling time (PSADT). In the absence of residual or recurrent cancer, PSA becomes undetectable by the first month after total prostatectomy (<0.1 ng/mL) [5]. No imaging study is necessary after definitive treatment for clinically localized prostate cancer before BCR unless there are concerns for complications such as a fistula or abscess [6].