Whether a patient with prostate cancer needs further treatment after radical prostate cancer surgery depends on two main points:
- Post-operative pathological diagnosis;
- The change in prostate-specific antigen (PSA) values after surgery.
In general, if the postoperative pathologic diagnosis is negative for cut margins, there is no invasion of vascular bundles or nerve roots, no invasion of the seminal vesicle glands or lymph nodes, and the postoperative PSA is consistently maintained at very low levels, at least less than 0.1 ng/ml, no further treatment is necessary.
If the postoperative pathological margins are positive, or if there is invasion of the vascular bundles or nerve roots, or if there is invasion of the seminal vesicle glands and lymph nodes, or if the postoperative PSA remains elevated above 0.2 ng/ml, further treatment needs to be considered.
- The first treatment option is endocrine therapy, also known as androgen blockade therapy, which is mainly treated with luteinizing hormone-releasing hormone analogue injections every 28 days.
- Or external radiation therapy, which uses a high-energy linear gas pedal to deliver high-energy particles to the target while avoiding normal tissue and significantly reducing side effects.
The evaluation of the treatment effect is mainly judged by the change in PSA before and after treatment.