After Treatment: Living as a Prostate Cancer Survivor

For most men with prostate cancer, treatment can remove or destroy the cancer. Completing treatment can be both stressful and exciting. You may be relieved to finish treatment, but find it hard not to worry about cancer growing or coming back. This is very common if you’ve had cancer.

For some men, the cancer may come back in other parts of the body, or it may never go away completely. These men may get hormone therapy or other treatments to help keep the cancer under control for as long as possible and to help with any symptoms they’re having. Learning to live with cancer that does not go away can be difficult and very stressful.

Follow-up care

Even if you have completed treatment, your doctors will still want to watch you closely. It’s very important to go to all of your follow-up appointments. During these visits, your doctors will ask you about any problems you may be having and may do exams and lab tests or imaging tests to look for signs of cancer or treatment side effects.

Some treatment side effects might last a long time or might not even show up until years after you have finished treatment. Your doctor visits are a good time to ask questions and talk about any changes, problems, or other concerns you have.

It’s important for all prostate cancer survivors to tell their health care team about any new symptoms or problems, because they could be caused by the cancer coming back or by a new disease or second cancer.

Doctor visits and tests

Your doctor visits will usually include PSA blood tests, possibly with digital rectal exams (DREs) if your prostate hasn’t been removed. These will probably begin within a few months of finishing treatment. How often you need follow-up visits and tests might depend to some extent on the stage of your cancer, the chance of it coming back, and what type of treatment you’ve had (or are getting).

For men who’ve completed treatment, most doctors recommend PSA tests about every 6 months or so for the first 5 years, and at least yearly after that. If you’re still getting treatment (such as hormone therapy) or if you and your doctor are just monitoring your cancer, testing might be done more often. Imaging tests, such as bone scans or PET scans, might also be done, depending on your medical situation and symptoms.

Prostate cancer can recur even many years after treatment, which is why it’s important to keep regular doctor visits and report any new symptoms (such as bone pain, unexpected weight loss, or problems with urination).

Ask your doctor for a survivorship care plan

Talk with your doctor about developing a survivorship care plan for you. This plan might include:

• A summary of the treatment you received
• A suggested schedule for follow-up exams and tests
• A schedule for other tests you might need in the future, such as early detection (screening) tests for other types of cancer, or tests to look for long-term health effects from your cancer or its treatment
• A list of possible late or long-term side effects from your treatment, including what to watch for and when you should contact your doctor
• Suggestions for things you can do that might improve your health, including possibly lowering your chances of the cancer coming back

Keeping health insurance and copies of your medical records

Even after treatment, it’s very important to keep health insurance. Tests and doctor visits cost a lot, and although no one wants to think of their cancer coming back, this could happen.

At some point after your cancer treatment, you might find yourself seeing a new doctor who doesn’t know your medical history. It’s important to keep copies of your medical records to give your new doctor the details of your diagnosis and treatment.

Can I lower the risk of prostate cancer progressing or coming back?

If you have (or have had) prostate cancer, you probably want to know if there are things you can do that might lower your risk of the cancer growing or coming back, such as exercising, eating a certain type of diet, or taking nutritional supplements. While there are some things you can do that might be helpful, more research is needed to know for sure.

Get regular physical activity

Some research has suggested that men who get regular physical activity after treatment might be less likely to die from their prostate cancer than those who don’t. It’s not clear exactly how much activity might be needed, but more seems to be better. More vigorous activity might also be more helpful than less vigorous activity. Further studies are needed to follow up on these findings.

Quit smoking

Some research has suggested that men who smoke are more likely to have their prostate cancer recur and are more likely to die from it than men who don’t smoke. More research is needed to see if quitting smoking can help lower these risks, although quitting is already known to have a number of other health benefits. If you want to quit smoking and need help, call the American Cancer Society at 1-800-227-2345. You can also learn more in our Guide to Quitting Tobacco.

Eat a healthy diet

Some studies have linked eating a diet that is high in added sugars, meat, and fat to a higher chance of dying from prostate cancer. On the other hand, a dietary pattern that’s high in foods such as fruits, vegetables, and whole grains has been linked with a lower chance of dying in some studies.

While eating a diet rich in fruits and vegetables and lower in animal fats might be helpful, more research is needed to be sure. We do know that a healthy diet can have positive effects on your overall health, with benefits that extend beyond your risk of prostate or other cancers.

About dietary supplements

So far, no dietary supplements have been shown to clearly help lower the risk of prostate cancer progressing or coming back. In fact, some research has suggested that some supplements, such as selenium, might even be harmful. This doesn’t mean that no supplements will help, but it’s important to know that none have been proven to do so.

Dietary supplements are not regulated like medicines in the United States – they do not have to be proven effective (or even safe) before being sold, although there are limits on what they’re allowed to claim they can do. If you are thinking about taking any type of nutritional supplement, talk to your health care team. They can help you decide which ones you can use safely while avoiding those that could be harmful.

If the cancer comes back

If your prostate cancer comes back at some point, your treatment options will depend on where the cancer is, what types of treatment you’ve already had, and your health. See Treating Prostate Cancer that Doesn't Go Away or Comes Back After Treatment.

For more general information on recurrence, see Understanding Recurrence.

Could I get a second cancer after treatment?

Men who’ve had prostate cancer can still get other cancers (known as second cancers). In fact, prostate cancer survivors are at higher risk for getting some other types of cancer, including:

• Small intestine cancer
• Soft tissue cancer
• Bladder cancer
• Thyroid cancer
• Thymus cancer
• Melanoma of the skin

Men who are treated with radiation therapy also have a higher risk of:

• Rectal cancer
• Acute myeloid leukemia (AML)

Because newer methods of giving radiation therapy can be aimed more precisely, the risk of these cancers might be lower today than it was in the past. But because these methods are newer, the possible long-term effects aren’t yet as clear.

Most experts don’t recommend any additional testing to look for second cancers in men who’ve had prostate cancer. Still, it’s important to let your doctor know about any new symptoms or problems you have, because they could be caused by the prostate cancer coming back, or by a new disease or second cancer.

Like other people, men who’ve had prostate cancer should follow the American Cancer Society guidelines for the early detection of cancer and stay away from tobacco products, which increase the risk of many types of cancers.

To help maintain good health, survivors should also:

• Get to and stay at a healthy weight.
• Stay physically active, and limit time spent sitting or lying down.
• Follow a healthy eating pattern that includes plenty of fruits, vegetables, and whole grains, and that limits or avoids red and processed meats, sugary drinks, and highly processed foods.
• Avoid or limit alcohol. If you do drink, have no more than 2 drinks per day.

These steps may also lower the risk of some other health problems.

See Second Cancers for more information about causes of second cancers.

Getting emotional support

Feelings of depression, anxiety, or worry are normal when prostate cancer is a part of your life. Some men are affected more than others. But everyone can benefit from help and support from other people, whether it’s friends and family, religious groups, support groups, professional counselors, or others.

Sexuality and feeling good about your body

Prostate cancer treatment can often affect sexual function. Learning to be comfortable with your body during and after prostate cancer treatment is a personal journey, one that is different for everyone. Information and support can help you cope with these changes over time. Learn more in Sexual Side Effects.

Bladder or bowel issues after treatment

Some prostate cancer treatments might also cause bladder or bowel problems. In some men these might go away over time, but for others they might be long lasting. Be sure you get the information and support you need to help you cope with these changes. To learn more, see Bladder and Bowel Incontinence.