Prostate cancer recurrence means cancer has returned or persisted after treatment intended to control the original disease. Recurrence may first appear only as a PSA rise, may be confined to the prostate or prostate bed, may involve pelvic lymph nodes, or may be metastatic to bone, distant lymph nodes or organs. These states are not interchangeable: where recurrence is located, how quickly PSA is rising, what treatment was used first and whether the cancer remains hormone-sensitive all change the next treatment options.
Prostate cancer can recur as biochemical-only, local, regional nodal or distant metastatic disease. Biochemical recurrence means PSA has risen after treatment before recurrent cancer is necessarily visible; its exact PSA definition is covered in the dedicated Biochemical Recurrence guide. Local recurrence means cancer is found in the prostate bed after prostatectomy or inside/around the prostate after radiation. Regional recurrence usually refers to pelvic lymph nodes. Metastatic recurrence means cancer is present at distant sites such as bone, distant nodes or visceral organs. Modern PSMA PET/CT can locate recurrence earlier than conventional imaging in many patients, but a negative scan does not exclude microscopic disease. Treatment depends on the original therapy, recurrence location, PSA kinetics, grade, symptoms, life expectancy and whether disease is still hormone-sensitive.
01What Types of Prostate Cancer Recurrence Are There?
Biochemical recurrence is the earliest detectable state for many patients
For most men followed after prostatectomy or radiation, recurrence is first suspected because PSA rises.
EAU states that PSA recurrence almost always precedes clinical recurrence after local treatment.
At this stage:
- there may be no symptoms;
- physical examination may be normal;
- CT or bone scan may be negative;
- and even PSMA PET can be negative when disease volume is microscopic.
The exact PSA thresholds after surgery and radiation belong to the dedicated biochemical recurrence definition page.
What is local recurrence?
Local recurrence means recurrent cancer is confined to the area of the original prostate treatment.
After radical prostatectomy, this typically means the:
- prostate bed;
- vesicourethral anastomosis;
- seminal-vesicle bed;
- or nearby soft tissue.
After radiation, local recurrence generally means viable cancer remains or returns:
- inside the irradiated prostate;
- at the dominant original tumor site;
- or immediately adjacent structures.
What is regional recurrence?
Regional recurrence means cancer has spread to lymph nodes within the regional pelvic drainage field.
PSMA PET has made small-volume nodal recurrence easier to identify than older CT criteria based primarily on lymph-node size.
Regional recurrence is biologically more advanced than disease confined only to the prostate bed or prostate, but it is not the same as widespread distant metastatic disease.
What is oligorecurrent or oligometastatic prostate cancer?
These terms describe a limited number of visible metastatic sites.
Examples include:
- one or a few pelvic or distant lymph nodes;
- one or a few bone lesions;
- or another small-volume pattern seen on molecular imaging.
Metastasis-directed treatment such as stereotactic radiation is increasingly studied in this setting.
However, current EAU guidance still treats metastasis-directed therapy as an evolving area rather than a universal replacement for standard systemic therapy.
What is distant metastatic recurrence?
Distant metastatic recurrence means prostate cancer is found outside the local/regional treatment area.
Common sites include:
- bone;
- distant lymph nodes;
- and, less commonly, visceral organs such as liver or lung.
Bone is a particularly common metastatic site for prostate adenocarcinoma.
What is the difference between recurrence and progression?
The terms overlap but are not identical.
Recurrence usually refers to cancer returning after a period of control following treatment.
Progression means known disease is becoming more extensive or resistant despite ongoing management.
For example:
- a patient with undetectable PSA after prostatectomy who later develops a rising PSA has recurrence;
- a patient with known metastatic disease whose scans worsen despite therapy has progression.
How common is PSA recurrence after local treatment?
EAU’s current treatment chapter states that approximately 27–53% of patients undergoing radical prostatectomy or radiation develop a rising PSA across published series.
That broad range should not be applied as a personal recurrence probability because it includes:
- different initial risk groups;
- different eras of imaging and treatment;
- different follow-up durations;
- and different recurrence definitions.
Core distinction: “the cancer came back” is incomplete information. The clinically useful statement is where recurrence is located, whether it is visible, how fast it is progressing and whether it remains hormone-sensitive.
02How Is Recurrent Prostate Cancer Detected and Located?
PSA remains the cornerstone after curative local treatment
EAU follow-up guidance states that PSA recurrence almost always appears before clinical recurrence after prostatectomy or radiation.
That makes serial PSA the main surveillance signal.
The interpretation differs by treatment:
- after prostatectomy, PSA should become undetectable;
- after radiation, PSA remains measurable and is interpreted relative to its post-treatment nadir.
The specific biochemical definitions are intentionally not duplicated here; see What Is Biochemical Recurrence After Prostate Cancer?
When should imaging be performed?
EAU recommends imaging at recurrence when the result will affect treatment planning.
Routine scans are not required in an asymptomatic patient with stable PSA after successful local treatment.
Why is PSMA PET/CT important?
PSMA PET/CT can detect prostate cancer deposits at lower PSA values than conventional CT or bone scintigraphy in many patients.
At recurrence it can help distinguish:
- prostate-bed recurrence;
- pelvic nodal disease;
- distant nodes;
- bone metastases;
- and selected visceral metastases.
Does PSMA PET find every recurrence?
No.
Detection depends on:
- PSA level;
- tumor volume;
- PSMA expression;
- lesion size;
- and technical factors.
At very low PSA, recurrent disease can remain microscopic and below scan resolution.
Therefore:
a negative PSMA PET means no recurrence was visible on that scan—not that recurrent cancer is biologically impossible.
Why can salvage radiation still be used after a negative PSMA PET?
AUA/ASTRO/SUO specifically advises not withholding prostate-bed salvage radiotherapy solely because PSMA PET is negative in a patient with a convincing post-prostatectomy recurrence pattern.
Early local microscopic disease is exactly the type of recurrence that may be invisible on imaging yet still curable with salvage radiation.
What is MRI used for after prior radiation?
Multiparametric MRI is particularly useful when recurrence is suspected inside an irradiated prostate.
EAU recommends prostate MRI to:
- localize abnormal areas;
- guide biopsy;
- and plan local salvage in patients fit enough for curative salvage treatment.
Why is biopsy important after radiation?
Local salvage after radiation can produce substantial:
- urinary toxicity;
- erectile dysfunction;
- stricture;
- fistula risk;
- and rectal injury depending on modality.
Because of that morbidity, current EAU guidance requires histological proof of local recurrence before definitive local salvage treatment after radiotherapy.
Can recurrence cause symptoms even if PSA is not rising?
Very rarely.
EAU notes that symptomatic recurrence without PSA rise is uncommon but can occur, particularly in aggressive or poorly differentiated variants.
Symptoms that should prompt evaluation include:
- new pelvic or skeletal pain;
- hematuria;
- progressive lower urinary tract symptoms;
- progressive lower-body edema;
- progressive bowel complaints;
- unexplained weight loss;
- fatigue;
- or sarcopenia.
Imaging rule: scans are most useful when they answer a treatment question. A scan should help determine whether recurrence is local enough for salvage therapy, regional, or already distant—not simply document every PSA fluctuation.
03How Is Local or Regional Recurrence Managed After Surgery or Radiation?
After prostatectomy, early salvage radiation is the main curative local strategy
When recurrence appears after radical prostatectomy and there is no distant metastatic disease, salvage radiotherapy to the prostate bed can still be curative.
Current EAU guidance recommends:
- early salvage IMRT/VMAT with image guidance after consecutive PSA rises when salvage is indicated;
- not waiting for a high PSA threshold once the decision for salvage radiotherapy has been made;
- and considering hormonal therapy in addition to salvage radiation according to recurrence risk.
Why does early salvage matter?
The probability that salvage radiation controls microscopic disease generally decreases as PSA rises.
AUA/ASTRO/SUO recommends delivering post-prostatectomy salvage radiation while PSA is ≤0.5 ng/mL when salvage radiation is being pursued.
Selected patients at particularly high risk can be considered for even earlier treatment below 0.2 ng/mL.
Does a positive surgical margin prove recurrence is local?
No.
A positive margin raises the probability that residual disease exists at the surgical site, but it does not exclude:
- pelvic nodal disease;
- or distant micrometastatic disease.
Margins are one variable among:
- PSA doubling time;
- Grade Group;
- pathological stage;
- node status;
- PSMA PET findings;
- and time to recurrence.
What if recurrence is found in pelvic lymph nodes?
Nodal recurrence can lead to several possible strategies depending on:
- number of involved nodes;
- whether nodes are pelvic or distant;
- prior radiation fields;
- PSA kinetics;
- and whether additional metastases are present.
Options can include:
- pelvic or nodal radiation;
- androgen deprivation with or without intensified systemic therapy;
- selected stereotactic treatment of limited nodal disease;
- or, in selected settings, salvage lymph-node dissection.
EAU notes that salvage lymph-node dissection evidence remains largely retrospective and complete durable biochemical control is not reliably achieved.
How is local recurrence after radiation different?
After radiation, the prostate remains but its tissues have already received a full curative radiation dose.
That creates two important requirements:
- confirm that recurrence is truly confined locally;
- choose salvage only in patients fit enough to tolerate the increased morbidity of treating previously irradiated tissue.
How often is recurrence after radiation actually isolated to the prostate?
Current EAU evidence cites a PSMA PET/CT study of 568 patients with rising PSA after primary radiotherapy who met Phoenix biochemical-recurrence criteria.
In that cohort:
- isolated local recurrence was detected in only 32%;
- distant metastases were present in 49%.
That finding is important because a rising PSA after radiation should not automatically be assumed to represent a purely local recurrence that can be cured by treating the prostate again.
Which local salvage options can be considered after radiation?
In highly selected patients with biopsy-confirmed local recurrence and no distant metastases, options can include:
- salvage radical prostatectomy;
- salvage HDR or LDR brachytherapy;
- stereotactic re-irradiation in experienced centers;
- cryotherapy;
- or HIFU in selected experienced/research settings.
Is one post-radiation salvage treatment clearly best?
No.
EAU summarizes a systematic review comparing salvage prostatectomy, HIFU, cryotherapy, SBRT and salvage brachytherapy.
Five-year recurrence-free survival across modalities was roughly in the 50–60% range in pooled observational data, but the evidence was heterogeneous and largely non-randomized.
The guideline therefore does not support declaring one universal local-salvage winner.
Why is salvage prostatectomy after radiation considered difficult?
Radiation causes:
- fibrosis;
- distorted tissue planes;
- reduced blood supply;
- and impaired wound healing.
EAU evidence reports substantially worse functional outcomes than primary prostatectomy, including high rates of urinary incontinence and erectile dysfunction.
For that reason, salvage prostatectomy belongs in experienced centers and carefully selected patients.
Local-salvage rule: the goal can still be curative, but only if disease location supports that goal. After prostatectomy, microscopic prostate-bed recurrence can be treated even with negative imaging; after radiation, biopsy confirmation and exclusion of distant disease become especially important before high-morbidity local salvage.
04What Does Metastatic Recurrent Prostate Cancer Mean?
Metastatic recurrence means disease is no longer confined to the original treatment region
Metastatic recurrent prostate cancer can involve:
- bone;
- distant lymph nodes;
- lung;
- liver;
- or other organs.
The presence of metastases changes the treatment goal from treating one local site alone to controlling disease throughout the body.
What is metastatic hormone-sensitive recurrent prostate cancer?
Hormone-sensitive metastatic disease means the cancer still responds to androgen suppression.
This can occur:
- at initial diagnosis;
- or years after prostatectomy/radiation as metastatic recurrence.
For recurrent metastatic disease, current EAU guidance makes systemic treatment central.
Is ADT alone still the usual modern treatment?
For most fit men with metastatic hormone-sensitive prostate cancer, no.
Modern management generally combines ADT with an androgen-receptor pathway inhibitor when feasible.
For selected patients—particularly those with high-volume/high-risk disease—docetaxel-based triplet therapy may also be discussed.
The exact regimen depends on:
- volume of metastatic disease;
- de novo versus metachronous recurrence;
- prior exposure to ADT, AR-pathway therapy or chemotherapy;
- fitness for chemotherapy;
- cardiovascular and metabolic comorbidity;
- drug interactions;
- and patient preference.
Why does metachronous recurrence matter?
Metachronous metastatic disease means metastases appear after a period of localized disease control.
Its biology can differ from prostate cancer that is metastatic at first diagnosis.
EAU notes that for metachronous low-volume metastatic disease, ADT plus an androgen-receptor pathway inhibitor is often an effective intensification strategy, while adding docetaxel can increase toxicity without clear evidence that every patient benefits from triplet treatment.
What is castration-resistant recurrent prostate cancer?
Castration-resistant prostate cancer (CRPC) means the disease progresses despite testosterone being suppressed to the castrate range.
Progression can be:
- biochemical;
- radiographic;
- or clinical.
CRPC can be:
- non-metastatic on conventional imaging;
- or metastatic (mCRPC).
Does a rising PSA always accompany metastatic progression?
No.
Current EAU follow-up guidance warns against relying on PSA alone in advanced disease.
In analyses of modern systemic-therapy trials:
- some men progressed radiographically without a parallel PSA rise;
- and nearly half of patients with radiographic progression in a TITAN secondary analysis had no concomitant PSA progression.
That is why metastatic disease requires:
- clinical assessment;
- PSA;
- laboratory monitoring;
- and appropriate imaging.
What treatments can be used for metastatic castration-resistant recurrence?
Treatment selection depends heavily on what the patient has already received.
Current EAU systemic options include, depending on eligibility:
- androgen-receptor pathway inhibitors;
- docetaxel;
- cabazitaxel;
- PARP-directed strategies for selected HRR/BRCA-altered cancers;
- 177Lu-PSMA radioligand therapy in eligible PSMA-positive disease;
- radium-223 in selected symptomatic bone-predominant disease without visceral metastases;
- and immunotherapy in biomarker-selected situations.
This page intentionally gives the disease-state framework rather than recreating a complete advanced-prostate-cancer drug-sequencing guideline.
Why are genetic tests more important after metastatic recurrence?
Metastatic disease can make both germline and tumor genomic testing clinically actionable.
Testing can identify:
- BRCA1/BRCA2 or other homologous-recombination repair alterations;
- mismatch-repair deficiency / MSI-high disease;
- and other molecular findings relevant to therapy or family counseling.
Treatment selection in advanced disease increasingly depends on both disease location and molecular biology.
Metastatic-recurrence rule: once distant disease is present, systemic control becomes central. The next distinction is not merely “PSA high or low,” but whether disease remains hormone-sensitive, how much metastatic disease is present, what treatments have already been used and whether actionable molecular targets exist.
05What Determines the Next Step After Prostate Cancer Recurs?
There is no single recurrence treatment because recurrence is not one disease state
The management plan is built from several layers.
1. What treatment was used first?
This changes what can safely be used next.
- After prostatectomy, salvage prostate-bed radiation is often the main potentially curative local treatment.
- After definitive radiation, the prostate has already received high-dose radiation, so salvage surgery or re-irradiation requires careful selection.
- After previous ADT or AR-targeted therapy, systemic treatment sequencing changes.
2. Where is the recurrence?
The location determines whether the treatment goal can still be local.
| Recurrence state | What is detected? | Typical treatment logic | Major limitation |
|---|---|---|---|
| Biochemical-only | PSA rise, no visible lesion. | Risk stratify; monitor selected low-risk disease or pursue early salvage based on original treatment. | Imaging may be negative because disease is microscopic. |
| Local after prostatectomy | Prostate-bed pattern, with or without visible lesion. | Early salvage radiotherapy ± hormonal therapy according to risk. | Local imaging can miss microscopic recurrence. |
| Local after radiation | Intraprostatic recurrence confirmed/localized. | Selected salvage prostatectomy, brachytherapy, SBRT re-irradiation, cryotherapy or HIFU in experienced settings. | Previously irradiated tissue increases urinary/rectal/sexual toxicity; distant disease must be excluded. |
| Regional nodal | Pelvic lymph-node recurrence. | Individualized nodal RT, systemic therapy and selected metastasis-directed approaches. | Microscopic disease may exist beyond visible nodes. |
| Limited distant / oligorecurrent | Small number of distant lesions. | Systemic therapy remains central; MDT may be considered in selected/evolving contexts. | Visible lesions may underestimate whole-body microscopic disease. |
| Widespread metastatic | Multiple bone, nodal and/or visceral metastases. | ADT-based systemic intensification; later therapy guided by resistance state and biomarkers. | Local treatment alone cannot control systemic disease. |
3. How aggressive is the recurrence?
Important variables include:
- PSA doubling time;
- Grade Group;
- pathological/clinical stage;
- time from initial treatment to recurrence;
- site and number of lesions;
- presence of visceral metastases;
- symptoms;
- and response to prior hormonal therapy.
The dedicated biochemical recurrence guide explains the formal EAU low- and high-risk BCR categories.
4. Is the recurrence hormone-sensitive or castration-resistant?
This distinction changes the entire systemic treatment framework.
A metastatic recurrence that has never been exposed to sustained androgen deprivation is usually treated as hormone-sensitive disease.
Progression despite castrate testosterone moves the disease into a castration-resistant state.
5. Can treatment still reasonably aim for cure?
Potentially curative salvage is most plausible when recurrence is:
- microscopic or confined locally after prostatectomy;
- biopsy-confirmed and localized after radiation;
- and there is no convincing distant metastatic disease.
Once recurrence is widespread metastatic disease, treatment usually aims for:
- long-term disease control;
- delaying progression;
- preventing skeletal and urinary complications;
- maintaining function and quality of life;
- and prolonging survival.
6. What symptoms need urgent assessment?
Recurrent prostate cancer can occasionally create urgent complications.
Seek urgent medical assessment for new leg weakness/numbness, loss of bladder or bowel control, severe new back pain, inability to urinate, or symptoms suggesting spinal cord compression or obstructive urinary complications. Metastatic prostate cancer can affect the spine and urinary tract, and delay can cause permanent harm.
7. What should patients ask at a recurrence visit?
- Is this biochemical-only, local, nodal or distant recurrence?
- What is my PSA doubling time?
- Did PSMA PET or MRI actually change the treatment plan?
- Is the goal still cure, long-term control or symptom control?
- How does my original treatment limit or shape salvage options?
- Is the disease hormone-sensitive or castration-resistant?
- Should germline or tumor genomic testing be performed?
- What urinary, sexual, bowel, bone and metabolic side effects should I expect from the next treatment?
Decision rule: recurrence treatment should not be selected from PSA alone. The clinically meaningful unit is PSA kinetics + original pathology + prior treatment + recurrence location + hormone sensitivity + patient fitness and goals.
→Prostate Cancer Recurrence States Compared
| Recurrence type | PSA | Imaging | Typical disease location | Main management implication |
|---|---|---|---|---|
| Biochemical-only recurrence | Rising according to treatment-specific definition. | May be negative. | Unknown / microscopic. | Use PSA kinetics and risk features; selected patients may be monitored or treated with early salvage. |
| Local recurrence after RP | Usually rising. | Can be visible in prostate bed, but may remain occult at low PSA. | Prostate bed / anastomosis. | Salvage prostate-bed RT ± hormonal therapy can be curative in selected patients. |
| Local recurrence after RT | Often meets or approaches Phoenix criteria. | MRI and PSMA PET can localize; biopsy needed before definitive local salvage. | Within irradiated prostate / local tissues. | Selected salvage RP, brachytherapy, SBRT, cryotherapy or HIFU in experienced settings. |
| Regional nodal recurrence | Variable. | PSMA PET often identifies small pelvic nodes. | Pelvic lymphatic drainage. | Nodal RT/systemic therapy; MDT approaches individualized and evolving. |
| Oligorecurrent metastatic disease | Variable; can be low. | Limited number of distant lesions. | Bone and/or distant nodes, occasionally other sites. | Systemic therapy remains important; MDT may be considered selectively. |
| Widespread metastatic recurrence | Often elevated but not always proportional to tumor burden. | Multiple distant sites. | Bone, distant nodes, viscera. | Systemic treatment is central; classify hormone-sensitive vs castration-resistant disease. |
| Castration-resistant progression | May rise, but radiographic progression can occur without a parallel PSA rise. | Progression despite castrate testosterone. | Non-metastatic or metastatic depending on imaging. | Therapy sequencing depends on prior agents, biomarkers, symptoms and metastatic pattern. |
Key Points
- Prostate cancer recurrence can be biochemical-only, local, regional nodal or distant metastatic.
- Biochemical recurrence is a PSA-defined recurrence signal and does not automatically mean metastases are present.
- The dedicated biochemical-recurrence page owns post-prostatectomy PSA ≥0.2 ng/mL confirmation, Phoenix nadir +2 after radiation, PSA bounce and formal BCR risk groups.
- Local recurrence after prostatectomy usually occurs in the prostate bed or vesicourethral-anastomotic region.
- Local recurrence after radiation occurs inside or around the previously irradiated prostate.
- Regional recurrence usually means pelvic lymph-node disease.
- Metastatic recurrence can involve bone, distant lymph nodes, lung, liver or other organs.
- EAU estimates a rising PSA occurs in roughly 27–53% of patients across prostatectomy/radiation series, but the range should not be used as a personal probability.
- PSMA PET/CT can localize recurrence earlier than conventional imaging in many patients, but sensitivity still depends on PSA and tumor volume.
- A negative PSMA PET does not exclude microscopic recurrent prostate cancer.
- EAU recommends recurrence imaging when the result will affect treatment planning.
- After prostatectomy, early salvage radiotherapy can still be curative even if imaging is negative.
- AUA/ASTRO/SUO recommends delivering salvage radiation at PSA ≤0.5 ng/mL when salvage RT is being pursued, with earlier treatment possible in selected high-risk patients.
- Regional nodal recurrence can require a combination of radiation and systemic therapy; salvage lymph-node dissection remains supported mainly by retrospective evidence.
- After radiation, local salvage requires careful restaging because recurrence may already be nodal or distant.
- EAU cites a 568-patient PSMA PET cohort after radiotherapy in which isolated local recurrence was found in 32% and distant metastases in 49% of patients meeting Phoenix BCR criteria.
- Histological confirmation is required before definitive local salvage after radiation because salvage procedures can cause substantial morbidity.
- Selected local recurrence after radiation can be treated with salvage prostatectomy, brachytherapy, stereotactic re-irradiation, cryotherapy or HIFU in experienced settings.
- No post-radiation local-salvage modality is universally superior; evidence is mostly observational and patient selection is critical.
- Metastatic hormone-sensitive recurrence is generally treated with ADT plus systemic intensification rather than ADT alone in most fit patients.
- Metachronous low-volume metastatic disease may be managed differently from de novo high-volume metastatic disease.
- Castration-resistant prostate cancer means disease progresses despite castrate testosterone.
- Advanced prostate cancer can progress radiographically without a parallel PSA rise, so metastatic follow-up cannot rely on PSA alone.
- mCRPC treatment can include chemotherapy, AR-pathway therapy, PARP-directed treatment for selected DNA-repair alterations, PSMA radioligand therapy, radium-223 and biomarker-selected immunotherapy.
- Germline and somatic genomic testing become especially relevant in metastatic recurrent disease.
- New severe back pain, leg weakness/numbness, bladder/bowel-control loss or urinary obstruction requires urgent medical assessment.
Clinical bottom line: prostate cancer recurrence is not one diagnosis with one treatment. A rising PSA may be the only evidence of recurrence, or modern imaging may localize disease to the prostate bed, the irradiated prostate, pelvic lymph nodes, bone or distant organs. Localized recurrence can sometimes still be treated with curative-intent salvage therapy, but the strategy depends fundamentally on whether the patient originally had surgery or radiation. Regional and limited metastatic recurrence require increasingly individualized combinations of local and systemic treatment. Once distant metastases are established, systemic therapy becomes central and the next major distinction is whether the cancer remains hormone-sensitive or has become castration-resistant. The correct recurrence plan therefore depends on location, PSA kinetics, grade/stage, original therapy, prior systemic treatment, molecular features, symptoms and patient fitness—not the PSA value alone.
Medical disclaimer: This article provides general medical education about prostate cancer recurrence after treatment. Recurrence management depends on original pathology, PSA kinetics, imaging, prior radiation/surgery/systemic therapy, hormone sensitivity, genomic findings, symptoms and individual health. New neurologic symptoms, severe back pain, urinary obstruction or rapidly worsening symptoms should be assessed urgently.
For the full disease framework, return to the Prostate Cancer hub. The previous guide, What Is Biochemical Recurrence After Prostate Cancer?, owns the exact PSA definitions and PSA-only recurrence thresholds. This page owns the broader local, regional and metastatic recurrence state and how recurrence location changes treatment logic.
Evidence Sources
- European Association of Urology — Prostate Cancer Treatment, 2026: PSA-only recurrence, PSMA PET/MRI, salvage radiotherapy, local recurrence after radiation, salvage procedures, metastatic hormone-sensitive and castration-resistant treatment.
- European Association of Urology — Prostate Cancer Follow-up, 2026: PSA surveillance, recurrence symptoms, imaging indications and progression during advanced disease.
- AUA/ASTRO/SUO — Salvage Therapy for Prostate Cancer Guideline, 2024: early salvage radiotherapy, PSMA PET, negative imaging and recurrence risk factors after prostatectomy.
- American Urological Association — current guideline index confirming the Advanced Prostate Cancer guideline was amended in 2026.
- National Cancer Institute — Prostate Cancer Treatment PDQ: recurrent prostate cancer, local failure after prostatectomy/radiation and systemic treatment of recurrent disease.
- National Cancer Institute — Hormone Therapy for Prostate Cancer: hormone therapy in recurrent, biochemical and metastatic disease.
- EAU Patient Information, updated February 2026 — advanced/metastatic prostate cancer and treatment categories.
