Treatment FAQ

what test do the va accept for recurrence of prostate cancer after radiation treatment

by Prof. Carole Heidenreich Published 2 years ago Updated 2 years ago

Treatment Options: When Cancer Returns After Radiation After prostate cancer is treated, patients usually undergo a blood test called PSA. PSA stands for Prostate Specific Antigen and is a simple blood test that gives a number.

Following a prostatectomy, the most widely accepted definition of a recurrence is a confirmed PSA level of 0.2 ng/mL or higher. After radiation therapy, the most widely accepted definition is a PSA that rises from the lowest level (nadir) by 2.0 ng/mL or more.

Full Answer

How does the VA rate prostate cancer?

Sep 04, 2018 · First run blood lab tests, See if prostate reactive enzyme levels are high, then consult with Urologist, Then look for nodules, get a MRI scan of your prostate, or a Sonogram of your prostate. I am currently taking the Saw Palmetto supplement right …

Should veterans with non-aggressive prostate cancer opt for radiation or surgery?

Jul 23, 2021 · Jul 23, 2021. Without getting into the difference between Biochemical Recurrence of PC after surgery and recurrence of PC after salvage radiation, the following applies: A diagnosis by a doctor that veteran has active prostate cancer (recurrence) is one of the necessary elements of a successful claim for PC after either procedure (post treatment).

Can I get VA compensation for erectile dysfunction from prostate cancer?

Mar 07, 2018 · Prostate cancer can usually be found through screening. Early prostate cancer usually does not cause symptoms, so screening can be crucial for detection. Tests to detect and diagnose prostate cancer can include: Physical examination; PSA blood test; Prostate biopsy; Imaging tests; Genetic testing; Transrectal ultrasound; MRI; PET scan; Bone scan; CT scan

What is considered a recurrence of cancer after a radical prostatectomy?

Dec 23, 2021 · After external beam radiotherapy. PSA levels usually get lower slowly over months or years. Defining the limit for cure is complicated and you should ask your cancer specialist. Usually a level of 2 ng/ml above the lowest point after treatment is taken as a sign of recurrence, or 3 increases in a row .

How do you check for prostate cancer recurrence?

If your prostate cancer has recurred, your healthcare provider will likely order some imaging tests to better determine where in your body the cancer has returned. Bone scans, CT scans, and MRIs are the most common tests ordered to find where in the body prostate cancer has recurred.Jan 27, 2020

What is percent of prostate cancer returns after radiation?

For the majority of men, prostate cancer is treatable and curable and does not come back after initial treatment. However, about 25%–33% of men with prostate cancer will experience a recurrence of their cancer after surgery or radiation.

Does prostate cancer come back after radiation treatment?

Prostate cancer can come back, even after you've had treatment and your doctor declared you cancer-free. Prostate cancer that returns after treatment is called recurrent prostate cancer. Prostate cancer returns for a couple of reasons: Some cancer cells were left behind after surgery or radiation therapy.May 19, 2021

Can prostate regenerate after radiation therapy?

During treatment, doctors use drugs, surgery, or other hormones to reduce androgens or block them from working. Androgen deprivation shrinks the prostate gland substantially. This is due to the loss of luminal cells, which form the inside of the hollow prostate. The prostate can regenerate when androgen is restored.May 12, 2020

How often does prostate cancer recur after radiation?

“In recent years, [for the] 30-40 percent of patients who elect radiation therapy, the cancer will recur,” noted Madi, who is Director of Urologic Oncology and Robotic Surgery at the Medical Center at Augusta University, as well as Professor in the Division of Urology.Aug 20, 2019

What should PSA levels be after radiation?

Recent studies have shown that for optimal results, PSA levels should be lower than 1 ng/ml, and even lower than 0.5 ng/ml. Levels that are above 1 or 2 ng/ml 12 to 18 months following completion of radiation treatments are very worrisome, because they indicate that the cancer may not have been eradicated.Mar 31, 2009

Can radiation be used twice for prostate cancer?

Cancer that is thought to still be in or around the prostate

Having radiation therapy again is usually not an option because of the increased potential for serious side effects, although in some cases brachytherapy may be an option as a second treatment after external radiation.

How do you prevent prostate cancer from coming back?

Even if you get regular exercise and eat nutritious foods, it's always possible that cancer may return. Research suggests, though, that these things you may lower your chances that your cancer will come back.
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Lifestyle Changes
  1. Less saturated fat. ...
  2. Less processed meat. ...
  3. Less sugar. ...
  4. Fruit and vegetables. ...
  5. Whole grains.
May 18, 2021

What should PSA levels be 3 months after radiation?

Patients were characterized by 3-month post-RT PSA values: <0.10 ng/mL, 0.10 to 0.49 ng/mL, and ≥0.50 ng/mL. The researchers found that a higher 3-month PSA level was strongly associated with biochemical progression-free survival (bPFS), prostate cancer-specific survival (PCSS), and overall survival (OS).May 29, 2018

Can you have radiotherapy twice?

Radiation therapy is a wonderful tool used to treat and often cure many cancers when the cancer is localized to one place in the body. In select cases, radiation therapy can be used a second time in the same patient. If cancer is being treated in a different area of the body, this is an easy question.Nov 11, 2009

What happens to the prostate after radiation therapy?

Radiotherapy to the prostate can cause some side effects, such as loose or watery poo (diarrhoea) and passing wee (urine) more often. Side effects tend to start a week or 2 after the radiotherapy begins. They gradually get worse during the treatment and for a couple of weeks after the treatment ends.

What does a PSA of 0.03 mean?

A lower PSA cutoff of 0.01 ng/mL in men following RP is an independent predictor of BCR. A higher PSA concentration of 0.03 ng/mL in men with no pathological evidence of prostate cancer may effectively define undetectable.Sep 11, 2015

What is the PSA of a prostatectomy?

The American Urological Association defines an initial PSA value of 0.2 ng/mL or greater followed by a subsequent confirmatory PSA value 0.2 ng/mL or greater as biochemical recurrence following prostatectomy.

Does a claimant have prostate cancer?

By definition the claimant does not have active prostate cancer. The PSA is trending toward to 2.2ng/mL (2 ng/mL or more above the nadir PSA) but has not yet arrived there to definitively state that biochemical recurrence of active prostate cancer has occurred.”. I have the following 2 responses:

What type of cancer is found in the prostate?

Nearly all forms of prostate cancer are adenocarcinomas . Adenocarcinomas can develop from gland cells. There are multiple types of other cancers which may start in the prostate, however, including: small cell carcinomas, neuroendocrine tumors, transitional cell carcinomas, and sarcomas. Often, prostate cancer grows slowly, but some forms may grow quickly and spread.

What is the presumptive condition for veterans exposed to Agent Orange?

Prostate cancer is a presumptive condition for veterans exposed to Agent Orange. “Presumptive” means that veterans do not have to provide a nexus (a link between their condition and service) to prove service connection.

How often do you change absorbent material for a veteran?

Absorbent materials include adult diapers or pads, and to be eligible or the 60% rating, absorbent materials must be changed four or more times per day. Erectile Dysfunction.

What are the factors that make a person more susceptible to prostate cancer?

These factors can include age, ethnicity, geography, family history, or genetic changes. Other risk factors can include exposure to certain chemicals and toxic substances, like Agent Orange.

Can burn pits cause prostate cancer?

While VA does not acknowledge disabilities as presumptively caused by burn pits, veterans can provide a nexus opinion from a medical professional to argue for service connection for their prostate cancer.

Does the VA grant erectile dysfunction?

Erectile dysfunction is a common residual of prostate cancer. The VA will only grant 0% for erectile dysfunction unless there is deformity with loss of erectile power. However, a grant of service connection for erectile dysfunction deems a veteran eligible for Special Monthly Compensation (SMC) for the loss of use of a creative organ.

Can you appeal a VA disability claim for prostate cancer?

However, if your claim for prostate cancer was denied, you still have options for appealing the decision.

Read Real Stories Of Men Who Underwent Treatment Of Enlarged Prostate At New York Urology Specialists

We offer treatment for prostate problems, including slow urine stream, frequent urination at night, difficulty emptying the bladder, and other problems to patients within driving distance to our offices as well as from other states and countries.

Risks Of The Procedure

As with any surgical procedure, certain complications can occur. Somepossible complications of both the retropubic and perineal approaches to RPmay include:

Rising Psa Without Evidence Of Metastases

Nubeqa® is an androgen receptor inhibitor with a distinct chemical structure that competitively inhibits androgen binding, AR nuclear translocation, and AR-mediated transcription approved for the treatment of men with non-metastatic castration-resistant prostate cancer .

What Happens To The Prostate After Radiation

The entire prostate gland is radiated when we treat the cancer. The prostate normally produces some of the fluid in the ejaculation. Radiation therapy has the side effect of damaging the glands in the prostate, so a lot less fluid is produced. The ejaculation may be dry or nearly dry.

Salvage Androgen Deprivation Therapy

Recurrence following RP can potentially be managed with salvage ADT, although data supporting this use is generally obtained from retrospective studies .

External Beam Radiation Therapy

In this type of therapy, a machine outside the body is used to focus the beams of radiation on the prostate gland. It is used to treat early stages of cancer and helps to relieve you from symptoms such as pain.

How To Return To An Active Sex Life After Prostate Cancer Treatment

No matter the cancer, treatments often cause side effects that affect patients quality of life. But with prostate cancer, the potential side effects can be particularly concerning to men who are trying to decide which approach is right for them.

How long does the VA pay for prostate surgery?

Just as an aside, I've seen some posts here stating that the VA pays 100% for 6 months after surgery for prostate. Then they call you in for a C&P exam. I had read that if they fail to call you in for the exam, that they continue to pay 100% until you are examined at the C&P. I wanted to advise that in my case the exam was 9 months post op (3 months late), but when they got to the award, they only paid for 6 months , not 9.

Who made some useful posts about recurrence after radiation?

Richard 50 made some useful posts about recurrence after radiation.

What is the most widely accepted definition of a recurrence?

From the Prostate Cancer Foundation: "In the post-prostatectomy setting, the most widely accepted definition of a recurrence is a PSA >0.2 ng/mL [more than 0.2] that is seen to be rising on at least two separate occasions at least two weeks apart and measured by the same lab."

What is a 0.2 PSA?

Generally, a PSA level of 0.2 (2/10th) is considered a recurrence of cancer after a radical prostatectomy . The key to a successful claim to reestablish the 100% rating is a written diagnosis (stating the cancer has returned) by a physician. If your VA doctor has not provided that diagnosis, you might consider seeing a private physician.

What does 0.2 mean for prostate cancer?

For those who previously had prostate cancer and surgery, a PSA of 0.2 indicates a biochemical recurrence after surgery as has been stated ad infinitum in this thread, including my posts.

Can prostate cancer return after radical prostatectomy?

In any case, if someone's prostate cancer has returned following a radical prostatectomy, I would suggest he ask his oncologist if the current cancer was, in fact, a metastasis of the original prostate cancer. If it metastasized, the original cancer becomes permanent and total for VA purposes, the site to which the original cancer metastasized (if outside the body system of the original cancer) is also assigned a 100%, but is subject to a future exam and possible reduction if treated successfully.

Does the VA schedule a PSA test?

As a result of the latest VA ruling, I have written to the VA via IRIS asking them why they do not schedule a PSA test when they schedule a C&P exam for PC for someone who has undergone a prostatectomy since that is the PSA is the only test that can confirm BCR. I followed that up with a question on what PSA standard they are using to determine BCR for someone who has undergone a prostatectomy. I will provide the forum with feedback once I hear back from the VA.

Can prostate cancer cells be resistant to radiation?

We have learned that prostate cancer cells are amazingly adaptable. In fact, they can quickly become resistant to external radiation, making it less effective.

Can you use DART for radiation?

For instance, the man who had External Be am Radiation Therapy (EBRT) alone may find benefit from a small dose of DART (Dynamic Adaptive Radiotherapy) followed immediately by seed implantation (depending on the location of the active cancer cells).

Can men with positive lymph nodes be treated with radiation?

Men with positive lymph nodes may be treated with radiation to the lymph nodes alone using the targeting sophistication of DART. Often these post-radiation recurrent patients will be prescribed hormonal therapy in addition to the new radiation.

What is the blood test for prostate cancer?

After prostate cancer is treated, patients usually undergo a blood test called PSA. PSA stands for Prostate Specific Antigen and is a simple blood test that gives a number. After treatment, that number should be low. If it starts to increase, that can be a signal of cancer coming back, also known as cancer recurrence.

What is it called when the PSA is high?

Often doctors will watch a series of PSA values to identify the trend. If the PSA number continues to increase, this is called “biochemical failure, ” and your doctors will investigate the cause. Sometimes doctors will order scans to see if there is cancer recurrence locally (in the prostate), or distantly (bones, other parts of the body). Treatment is different depending on where the cancer is found.

Is salvage brachytherapy a good treatment for prostate cancer?

More follow up is needed and the complete results will be reported with longer follow up, but this study shows that salvage brachytherapy may be another option in the treatment of recurrent prostate cancer after radiation therapy.

How long does prostate cancer last after radiation?

They focused specifically on men whose cancer had returned three to four years on average after initial treatment with radiation.

What is PGA prostate cancer?

Prostate cancer is often a multifocal disease, meaning that several tumors can be present in different parts of gland at the same time. Not all of these tumors are equally problematic, however. And it’s increasingly thought that the tumor with the most aggressive features — called the index lesion — dictates how a man’s cancer is likely to behave overall. That concept has given rise to a new treatment option. Called partial gland ablation (PGA), and also focal therapy, it entails treating only the index lesion and its surrounding tissues, instead of removing the prostate surgically or treating the whole gland in other ways. Emerging evidence suggests that PGA controls prostate cancer effectively, but with fewer complications such as incontinence.

Did the men get radiation for prostate cancer?

All the men had initially been given radiation for their prostate cancer with an intent to cure the disease, but the cancer had returned. At that point they had their prostates surgically removed. Following that, sections of their tumors had been mounted on slides for a pathologist’s review, and then put into storage.

How much radiation is needed for prostate cancer?

radiation oncology departments — standard doses for external beam radiation of the prostate were at or below 60 Gy.

What percentage of radiation patients experience a temporary PSA bounce?

Dr. Horowitz found that about 20 percent of patients who are treated with radiation therapy experience the non-threatening and temporary PSA bounce.

How often do doctors measure PSA?

After radiation treatment, doctors typically measure the PSA level every three months in a patient for the first year, and every six months thereafter. During the first year or two, patients normally experience a decline in their PSA blood test score.

When a PSA falls, is there a predictor of future survival?

However, the study also indicated that, when a PSA is falling, there is no specific number that predicts future survivability.

Does PSA fall lower?

According to a study published in the International Journal of Radiation Oncology/Biology/Physics (March 16, 2006), the answer is yes: The longer period of PSA fall and lower PSA nadir predicts a higher chance of disease-free survival, find more info.

Does a PSA bounce indicate cancer?

One exception is the phenomenon of the widely-seen PSA “bounce,” where the PSA level rises shortly after treatment. But this bounce does not indicate the cancer is returning. Nor does it suggest that the patient will die of prostate cancer any sooner than patients without a bounce, according to Eric M. Horiwitz, MD, from Fox Chase Cancer Center in Philadelphia, PA, in an article in Medscale Medical News.

Can prostate cancer be treated with radiation?

Today many men choose some form of external beam radiation therapy over surgery to treat their prostate cancer. But can a rising or falling PSA (prostate-specific antigen) level after radiation treatment predict whether the cancer will return?

Salvage Androgen Deprivation Therapy

Recurrence following RP can potentially be managed with salvage ADT, although data supporting this use is generally obtained from retrospective studies .

What Are Antiandrogens And Should They Be Part Of My Treatment Plan

Antiandrogens can be helpful in preventing the flare reaction associated with LHRH agonists resulting from an initial transient rise in testosterone. Their use for at least the first 4 weeks of LHRH therapy can relieve the symptoms often seen from the flare reaction, ranging from bone pain to urinary frequency or difficulty.

What Will I Learn By Reading This

When you have treatment for your prostate cancer, you may have erectile dysfunction also known as impotence. Erectile dysfunction is a very common side effect . Side effects from prostate cancer treatment are different from one man to the next. They may also be different from one treatment to the next. Some men have no erectile dysfunction.

How Prostate Cancer Recurrence Is Detected

Following surgery for prostate cancer removal, the majority of patients will have regular appointments to check in and assess recovery progress with their healthcare provider or preferred oncologist. At each of these visits, your doctor will draw blood to run tests on various levels of biomarkers, hormones, and immunological markers, including PSA.

Can I Have Radiation First And Then Surgery

With 3D conformal radiotherapy, intensity modulated radiation therapy , and brachytherapy, local tissue damage is often kept at a minimum, and surgeons at some of the larger cancer centers have been seeing improved results with salvage prostatectomy performed after radiation.

Scheduling Appointments For Enlarged Prostate Treatment At New York Urology Specialists

We have excellent reviews from patients and their partners. Information for out-of-state and international patients. Find out our office hours or directions to our office.

What Does Psa Velocity Mean

PSA velocity or PSA doubling time, both of which measure the rate at which your PSA rises, can be a very significant factor in determining is the aggressiveness of your cancer.

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