From The Decision:
- Patients often ask about the cancer coming back. If the prostate is removed and the cancer is already “silently” in a lymph node or just outside the prostate, then cancer is still in the body after the prostate is removed.
- The way you know this has happened is that the PSA will slowly rise “after” the prostatectomy.
- So the cancer did not come back, it was outside the prostate at the time of the surgery.
- If the cancer “comes back” after radiation, well that is a bit different.
- There is always a chance that the radiation did not “kill” all the cancer cell. In the case of external beam, maybe the dose was not strong enough. In the case of seeds, maybe a “skip’ area where the activity of the seeds missed a spot.
- In radiation, there is always the chance as well that as well, the cancer was outside the gland before the treatment.
So, did the cancer come back…or was it there all along. I speak a lot about luck in the treatment of prostate cancer. you’re lucky if your Gleason’s is low, your disease volume is low, and confined to the prostate.