Treatment of recurrent prostate cancer

If there is a new increase in PSA after treatment of prostate cancer, appropriate clarifications or examinations such as MRI and PSMA PET/CT must be carried out in order to distinguish whether it is a local or distant recurrence. Over 50% of recurrences are local recurrences.

In the case of a local recurrence, a large number of treatment alternatives (surgery, conventional radiation, Cyberknife therapy, cryotherapy, focused ultrasound (HIFU), brachytherapy) are available. Systemic therapy (anti-hormonal therapy) is preferably used when patients are not eligible for an invasive procedure due to their poor general condition or when they do not consent to an invasive procedure. The risks of invasive therapy such as bleeding, urethral strictures, fistulas, incontinence and impotence must be taken into account and weighed up. The treatment indication must be analyzed very critically, especially in older or multimorbid patients.

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Cyberknife technology for the treatment of recurrent prostate cancer

In this video, the possibilities of Cyberknife therapy for recurrent prostate cancer are discussed with our cooperation partners. A patient who was treated a few years ago in our center for recurrent prostate cancer also describes his personal experience with this therapy and how he felt afterwards.

Cyberknife radiosurgery for recurrent prostate cancer

Cyberknife radiosurgery is a very effective and safe therapy alternative in addition to the previously known therapy options. With the highest level of precision, small, sharply delineated tumors can be treated on an outpatient basis in just a single appointment. Risk structures such as the urethra, urinary bladder or rectum can usually be spared with this technique.


High-resolution imaging (PSMA PET/CT and MRI) and precisely placed gold markers for tumor tracking are the basic requirements for effective and safe Cyberknife treatment of local recurrence. Without appropriate imaging, an exact target volume definition cannot be guaranteed. Close cooperation with highly specialized partners in radiological diagnostics is important here. In our center this is the case with selected experts in the filed.

A small procedure is required to apply the gold marker, which is carried out on an outpatient basis as part of the treatment planning with our urology partners shortly before the actual treatment under local anesthesia. This is an easy procedure and has few complications.

Side effects, risks

Possible complications depend on the size and localization of the recurrence. In principle, the same side effects and risks are to be discussed as described under the point “Prostate carcinoma”, only the probability of occurrence is lower due to the significantly smaller radiation volume.

Follow up

In order to check the success of the therapy, the PSA value is checked 3 months after therapy, and then every six months.

The exact procedure and individual questions will be discussed in detail with our experts in our center.