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Follow up after brachytherapy (interstitial radiation therapy) for prostate cancer

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Alan J. Wein, MD
Last Modified: January 20, 2002

Dear OncoLink "Ask The Experts,"

My father has undergone brachytherapy (interstitial radiation therapy) in combination with Lupron 5 months ago. We can find no information about the proper screening program to monitor for tumor recurrence. Is monitoring of PSA a useful modality? Should CT/MRI be done regularly? Thank you!  

Alan J. Wein, MD, Professor and chair of the Division of Urology at the University of Pennsylvania School of Medicine and Chief of Urology at the Hospital of the University of Pennsylvania, responds:

Your father's treating radiation oncologist should issue follow up instructions after his brachytherapy for prostate cancer.

PSA monitoring is useful. In general, a periodic PSA should be done every 3 months after brachytherapy. It is not unusual for the PSA to rise and fall over the course of one year following treatment. At one year, the PSA should be less than 2.0 ng/ml. The patient should also be monitored for urinary obstructive symptoms, which can occur just after interstitial radiation therapy. CT/MRI is not generally done unless there is a specific problem.