Do Men with Prostate Cancer who Undergo Surgery Need Radiation Therapy Too?

By Carol Kornmehl, M.D., FACRO

There are a number of treatment options for men with prostate cancer. These include a surgical procedure, known as radical prostatectomy, as well as radiation therapy. Are there any situations wherein a man who undergoes a radical prostatectomy will need radiation therapy afterwards?

The answer is yes, in special circumstances. Such radiation therapy is known as salvage radiotherapy, and is advisable for men whose PSA levels rise after surgery, as well as for those whose PSA levels never fully decline. The reason is that radiation therapy can increase the odds of survival for such men.

A recent study reviewed the data of 635 men with rising PSA levels after radical prostatectomy. In the study, 160 of the men received salvage radiation therapy, 78 received salvage radiation therapy and hormonal therapy (which lowers the level of prostate cancer stimulating male hormones in the blood stream), and 397 received no treatment.

Over the ensuing ten years, of the men who received salvage radiation therapy alone or radiation therapy plus hormonal therapy, the rate of death from prostate cancer was nearly 60% less than that of the men who were not treated.

Salvage radiation therapy is noted to be most beneficial for men with rising PSA levels when it is administered promptly after the problem is identified. In contrast, if radiation therapy for men with climbing PSA levels is deferred more than two years after the initial PSA spike, no benefit is noted.

Additional analysis revealed that the beneficial effect of salvage radiation therapy was confined to those men whose PSA levels doubled in less than six months, suggesting that a rapid PSA doubling time is indicative of more aggressive disease.

Therefore, the good news is that for men whose PSA levels climb after radical prostatectomy, radiation therapy can be life saving.

Dr. Kornmehl is a board certified radiation oncologist and author of the critically acclaimed consumer health book, “The Best News About Radiation Therapy” (M. Evans, 2004). She may be contacted via, her website.

Copyright 2008 by Carol L. Kornmehl. No part of this article may be reproduced or copied without express written permission by the author or

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