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The completion of prostate cancer treatment can bring both relief and worry. When caught early, initial treatment may mean you are considered free of disease. Most men will live cancer-free for years, and some even the rest of their lives. But you may also feel worried, anxious, or fearful that your cancer may come back.

Cancer recurrence is the return of cancer after a period when no cancer cells could be detected in the body. The fear of recurrence is normal and reasonable for all cancer survivors. It is important to remember that although you cannot control whether your cancer recurs, you can control how much you let the fear of recurrence affect your life.

Fortunately the five year survival rate for men with localized prostate cancer is nearly 100 percent. However, up to 40 percent of men will experience a recurrence, so it is important to understand your risk for recurrence.

When a man has treatment for prostate cancer, his PSA level will drop significantly. Regular testing with PSA is one of the tools doctors will use to measure if the cancer has returned.

Biochemical Recurrence

When PSA levels rise to a certain threshold after prostate cancer treatment, this is known as biochemical recurrence. This means that some cancer cells have survived and are producing PSA. If this happens, the doctor will order additional tests and make recommendations for how to manage your disease. Just as you did at the time of diagnosis, consider a second opinion and seeking care from a multidisciplinary team. Click here to learn more about choosing your healthcare team.

There are differing opinions in the medical community about how best to manage a biochemical recurrence from immediate treatment to delayed treatment. Many factors will need to be considered, including the characteristics of your initial cancer, the rate of your PSA doubling time, your initial treatment option, and your personal health. Talk with your healthcare team to make a plan. Dr. Alicia Morgans, a medical oncologist specializing in prostate cancer care, speaks on biochemical recurrence in the video below.

Metastatic Prostate Cancer

When the PSA levels rise and tests and scans show prostate cancer in other parts of the body, such as the bones, this means the cancer has returned and is now metastatic prostate cancer.

There are many treatments available today to help patients with metastatic prostate cancer. Click here to learn more about these treatments and advanced disease.

Tips for Coping

Accept your fears. It is common to experience some fear about your cancer recurring. Telling yourself not to worry or criticizing yourself for being afraid won’t make these feelings go away. Accept that you are going to experience some fear and focus on finding ways to help yourself manage the anxiety.

It may also help to remember that the fear usually lessens over time, and that you won’t always feel so anxious. Be aware that your anxiety may temporarily increase at certain times, such as before follow-up care appointments, around the anniversary date of your diagnosis, or if a friend is diagnosed with cancer.

Don’t worry alone. Talking about your fears and feelings or writing down your thoughts in a journal can help reduce your anxiety. Talking and thinking about your concerns can help you explore the issues underlying your fear. Fear of recurrence might include fear of having to repeat cancer treatment, losing control of your life, or facing death.

Many cancer survivors find joining a support group to be helpful. Support groups offer the chance to share feelings and fears with others who understand, as well as to exchange practical information and helpful suggestions. Click here to find one of ZERO’s Us TOO local or virtual support groups. If you’re looking for one-on-one support from a prostate cancer survivor, explore ZERO’s MENtor program.

Adopt a healthy lifestyle. Eating a well-balanced diet, exercising regularly, and getting enough sleep helps you feel better physically and emotionally. Doctors do not know why cancer recurs in some people and not in others, but avoiding unhealthy habits, like smoking and excessive drinking, may help reduce the risk of recurrence. Adopting a healthy lifestyle will also lower your chances of developing other health problems. Visit our Healthy Living section for more information.

Reduce stress. Finding ways to lower your stress will help lower your overall level of anxiety. Experiment with different ways of reducing stress to find out what works best for you. Despite your best efforts to stay well, you may find yourself overwhelmed by fear or recurrent thoughts of illness. If in doubt, talk with your doctor or nurse and consider a referral for counseling. ZERO360, ZERO’s free comprehensive support program, can also help find emotional support services and resources.

Counseling can help with:

  • Being worried or anxious most of the time
  • Connecting with your partner due to ongoing side effects from treatment
  • Feeling hopeless about your future
  • Having trouble sleeping or eating well
  • Not participating in activities you used to enjoy
  • Having trouble concentrating or making decisions
  • Being unusually forgetful

Other resources on recurrence:

Recurrent Disease – Lantheus Resource