About this page. This is a plain English summary of follow-up after prostate cancer treatment. It does not replace medical advice from your own doctor or specialist.
For full information and references, please read the detailed page.
Why follow-up matters
Follow-up after prostate cancer treatment has two main jobs:
- To spot any sign of cancer coming back early.
- To support recovery from treatment - continence, sexual function, and general wellbeing.
The schedule is set by your specialist, based on your original cancer, the treatment you had, and how recovery is going. The general patterns below are a guide only.
PSA after surgery to remove the prostate
After a radical prostatectomy, the PSA blood level should fall to very low (undetectable). A typical pattern is:
- First PSA at about 6 weeks after surgery.
- Then every 3 months for the first year.
- Every 6 months in years 2 to 3.
- Once a year after that, if PSA stays stable.
A rising PSA after surgery is called biochemical recurrence. It does not always mean widespread cancer, but it does prompt more tests to decide on next steps.
PSA after radiotherapy
After radiotherapy, the PSA falls more slowly and does not reach undetectable levels. A rise of 2 ng/mL above the lowest value is usually used as the threshold for biochemical failure. PSA is generally checked every 3 months for the first year, then every 6 months for years 2 to 3, then yearly.
Active surveillance
For low-risk prostate cancer that is being watched rather than treated, follow-up usually includes regular PSA, clinic reviews, and periodic MRI and/or repeat biopsy. See the short version: active surveillance.
Imaging
Routine scans are not needed for most men whose PSA is stable. Scans (such as MRI, bone scan, or PSMA-PET) are usually arranged when:
- The PSA is rising in a pattern that suggests recurrence.
- New symptoms suggest cancer may have returned or spread.
- Treatment decisions need more staging information.
Recovery support
Follow-up visits are not just about PSA. They also review:
- Continence recovery after prostate surgery.
- Sexual rehabilitation after prostatectomy.
- The men's health pharmacist service for medication and device support.
Red flags - contact the clinic sooner if you notice
- New or worsening bone pain, especially in the back or hips.
- Unexplained weight loss or ongoing fatigue.
- Blood in the urine or semen.
- Difficulty passing urine, or sudden inability to pass urine (this needs urgent care).
- New leg weakness or numbness.
Urgent symptoms (sudden inability to pass urine, severe bleeding, or new leg weakness) should not wait - go to an emergency department or call 000.
What you can do next
- Read the full detailed page with references.
- Short version: the men's health service.
- Short version: prostate cancer.
- Request a second opinion if you have a new PSA change and would like a review.
- Call 02 8382 6980 for follow-up appointments.