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Life after treatment

For most people, the cancer experience doesn’t end on the last day of treatment. Life after cancer can present its own challenges. You may have mixed feelings when treatment ends, and worry that every ache and pain means the cancer is coming back.

Some people say that they feel pressure to return to ‘normal life’. It is important to allow yourself time to adjust to the physical and emotional changes, and establish a new daily routine at your own pace. Your family and friends may also need time to adjust.

Cancer Council 13 11 20 can help you connect with other people who have had cancer and provide you with information about the emotional and practical aspects of living well after cancer.

Download our booklet ‘Living Well after Cancer’

After treatment ends, you will have regular appointments to monitor your health, manage any long-term side effects and check that the cancer hasn’t come back or spread. During the check-ups, you can discuss how you’re feeling and mention any concerns, and may have a physical examination, x-rays, scans and a PSA test.

Depending on the type of treatment you had, PSA results will vary. After surgery, there should be no prostate cells left to make PSA antigen and your PSA level should drop quickly to 0 (or to a level that can’t be detected). After radiation therapy, your PSA level will drop gradually and it may take 2–3 years for your PSA to reach its lowest level. If you have ADT as well as radiation therapy, your PSA level will generally be very low while undergoing treatment.

The usefulness of the PSA test will vary. If you had localised prostate cancer, it can help detect the return of any cancer cells. With advanced prostate cancer, particularly when the Grade Group or Gleason score is very high, the PSA test is less useful.

Your doctor will also consider your symptoms and the results of other blood tests and scans. These all help to build a picture of what is happening to the cancer that is more accurate and informative than just the PSA test alone.

Talk to your doctor about how often you will need to have check-ups or a PSA test. Over time, if there are no further problems, your check-ups will become less frequent. If you notice any new symptoms between check-ups, you should let your GP or specialist know.

When a follow-up appointment or test is approaching, many people find that they think more about the cancer and may feel anxious. Talk to your treatment team or call Cancer Council
13 11 20 if you are finding it hard to manage this anxiety.

Check-ups will become less frequent if you have no further problems. Between follow-up appointments, let your doctor know immediately of any symptoms or health problems.

Sometimes prostate cancer does come back after treatment, which is known as a recurrence. If your PSA level starts to rise and the cancer has not spread beyond the prostate, this may mean you still have cancer cells in the prostate area. If this happens, you may be monitored with regular blood tests or you may be offered further treatment, which is known as salvage treatment.

Your options will depend on the treatment you had. If you had surgery, you may be offered radiation therapy, and if you had radiation therapy, you may be offered ADT. If the cancer has spread beyond the prostate, ADT is usually recommended. Surgery may be an option in some cases. You may be offered palliative treatment to ease symptoms.

It is possible for the cancer to come back in another part of your body. In this case, you may have treatment that focuses on the area where the cancer has returned. Talk to your doctors about the options. You can also call Cancer Council 13 11 20 for more information.

If you have continued feelings of sadness, have trouble getting up in the morning or have lost motivation to do things that previously gave you pleasure, you may be experiencing depression. This is quite common among people who have had cancer.

Talk to your GP, as counselling or medication—even for a short time—may help. Some people are able to get a Medicare rebate for sessions with a psychologist. Ask your doctor if you are eligible. Cancer Council SA operates a free cancer counselling program. Call Cancer Council
13 11 20 for more information.

For information about coping with depression and anxiety, call Beyond Blue on 1300 22 4636 or visit beyondblue.org.au. For 24-hour crisis support, call Lifeline 13 11 14 or visit lifeline.org.au.

This information is reviewed by

This information was last reviewed in March 2020 by the following expert content reviewers: Dr Amy Hayden, Radiation Oncologist, Westmead and Blacktown Hospitals, and Chair, Faculty of Radiation Genito-Urinary Group (FROGG), The Royal Australian and New Zealand College of Radiologists, NSW; Prof Shomik Sengupta, Professor of Surgery and Deputy Head, Eastern Health Clinical School, Monash University, and Visiting Urologist and Uro-Oncology Lead, Urology Department, Eastern Health, VIC; A/Prof Arun Azad, Medical Oncologist, Urological and Prostate Cancers, Peter MacCallum Cancer Centre, VIC; Ken Bezant, Consumer; Dr Marcus Dreosti, Radiation Oncologist, GenesisCare, and Clinical Strategy Lead, Oncology Australia, SA; A/Prof Nat Lenzo, Nuclear Physician, Specialist in Internal Medicine, Group Clinical Director, GenesisCare Theranostics and The University of Western Australia, WA; Jessica Medd, Senior Clinical Psychologist, Department of Urology, Concord Repatriation General Hospital, and HeadwayHealth Clinical and Consulting Psychology Services, NSW; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council Western Australia; Graham Rees, Consumer; Kerry Santoro, Prostate Cancer Specialist Nurse, Southern Adelaide Local Health Network, SA; A/Prof David Smith, Senior Research Fellow, Cancer Research Division, Cancer Council NSW; Matthew Starr, Consumer.