Dr. Parker on the Optimal Timing of Salvage Therapy in Prostate Cancer

Chris Parker, MD, consultant clinical oncologist, The Royal Marsden NHS Foundation Trust, discusses the optimal timing of salvage radiotherapy for men with prostate cancer.

The phase 3 RADICALS-RT trial evaluated the superiority of adjuvant radiotherapy versus salvage radiotherapy after radical prostatectomy. While adjuvant radiotherapy may be a more effective treatment, salvage radiotherapy can spare patients the toxicities associated with radiotherapy.

Salvage therapy should be implemented early for men who have recently undergone a radical prostatectomy rather than after they have a dramatic rise in their prostate-specific antigen (PSA), says Parker. Men should be considered for radiation as soon as their PSA begins to rise after surgery.

While PSA does not indicate which patients have prostate cancer, it serves as an early marker of recurrence in men who have undergone radical prostatectomy, explains Parker.

As such, rising PSA may indicate recurrence early enough that salvage radiotherapy can be curative, concludes Parker.