Clinical manifestations of prostate cancer recurrence

Currently, radical prostatectomy is one of the main methods for treating localized prostate cancer. However, many patients face the problem that after prostate cancer treatment, the chance of recurrence is very high, and patients have to undergo repeated treatments. Moreover, many people only discover the recurrence when the condition is very serious.

Clinical recurrence mainly refers to the recurrence of prostate cancer that can be detected clinically through direct physical examination or imaging methods. Patients with biochemical recurrence should undergo a comprehensive evaluation including rectal digital examination, B-ultrasound examination, ultrasound-guided puncture, bone scan and CT. If clinical evidence of prostate cancer recurrence is found, it can be called clinical recurrence of prostate cancer. If it is judged that clinical recurrence has occurred, it should be determined what kind of clinical recurrence it is, whether it is local recurrence, regional lymph node metastasis or distant metastasis. Choose an appropriate treatment plan based on the results of the comprehensive evaluation.

Important factors that help distinguish local recurrence from distant metastasis include: the timing of PSA increase after surgery, PSA velocity, PSA doubling time, pathological stage and Gleason score. The probability of only local recurrence after radical prostatectomy is greater than 80% in the following situations: PSA increase occurs 3 years after surgery, PSA velocity>0.75ng/(ml.y); PSADT≥11 months; Gleason score≤6; pathological stage≤pT3a.

Preventing recurrence of prostate cancer after surgery

1. Exercise in moderation: Patients after prostate cancer surgery should adhere to proper physical exercise and try to choose gentle exercise, such as fitness running, walking, various aerobics, Tai Chi, etc., which will help improve the efficacy of drugs.

2. Anal lifting exercises: Prostate cancer patients can perform anal lifting exercises in the early stage after surgery. Lift the anus forcefully for 2 to 6 seconds (the specific time should be based on what you can tolerate without being uncomfortable), then relax and rest for 2 to 6 seconds, tighten the pelvic floor muscles as long as possible, repeat 10 to 15 times, exercise 3 to 5 times a day, and continue for more than 8 weeks or longer.

3. Regular follow-up: Postoperative follow-up is very important. You should have a follow-up every 3 months in the first year after surgery, every 6 months after the second year, and once a year after 5 years. The follow-up includes: prostate specific antigen test (PSA), rectal examination, CT, etc.

4. Diet "mix and match": After surgery, patients should choose soft, light, non-irritating and easily digestible soft food or semi-liquid diet, and are required to eat small meals frequently, reduce water intake moderately, and avoid smoking, drinking alcohol, and coffee.