Follow-up after treatment

What is follow-up?

If you’ve had a treatment that aimed to get rid of your prostate cancer, such as surgeryradiotherapy or brachytherapy, you will have regular check-ups afterwards. This is often called follow-up.

The aim of your follow-up appointments is to:

  • check how your cancer has responded to treatment
  • help you deal with any side effects of treatment
  • give you a chance to raise any concerns or ask any questions.

Is my cancer cured?

Although you’ve had treatment aimed at getting rid of your prostate cancer, your doctor or nurse won’t usually use the word ‘cure’. Instead they may say you’re ‘in remission’. This means there is no sign of cancer.

Unfortunately, your doctor or nurse can’t say for certain whether your cancer will come back. Each cancer is different and the success of your treatment will depend on many things. But they can tell you how you are doing and what is expected.

When and where will I have my appointments?

Your follow-up appointments will usually start two or three months after treatment. You will then have appointments every three to six months. Around two years after your treatment, you may start to have appointments less often. Each hospital will do things slightly differently, so ask your doctor or nurse for more details about how often you will have follow-up appointments.

If your treatment was part of a clinical trial, how and when you have follow-up appointments will vary. The research nurse or doctor will give you more information about your follow-up plan.

Where you have your appointments will depend on the services in your area and on your own situation. Follow-up appointments could be:

  • at the hospital where you had your treatment
  • at another hospital closer to where you live
  • at your GP surgery
  • on the phone to your doctor or nurse, rather than going to the GP surgery or hospital.

The place where you have your follow-up appointments may also change. For example, you might have your first few appointments at hospital and then be offered follow-up at your GP surgery.

Wherever you have your appointments, you should be given the details of someone to contact at any time if you have any concerns, such as new symptoms or side effects.

Telephone-based follow-up

If your PSA level remains stable six months after treatment, you might be able to have your PSA levels
checked remotely.

You’ll still have PSA tests done at the hospital or your GP surgery, but you won’t have to go back again to get your results. Instead, your hospital doctor, nurse or GP will telephone or write to you about the results, or just to let you know that they don't need to see you.

If your PSA rises, you will be given an appointment at the hospital to talk about what this might mean. 

Men often prefer this type of follow-up, as it means you can avoid going to hospital appointments when you're feeling well and don't have any concerns.

Your doctor or nurse will give you information about the possible side effects of your treatment, such as urinary problems or sexual problems, and any symptoms to look out for, as well as details of who to call if you notice any changes. You, or your doctor or nurse, can arrange an appointment at any point if you have any questions or concerns.


At some hospitals, you may have fewer follow-up appointments, and be encouraged to take greater control of your own health and wellbeing. This is sometimes called self-management.

You may be able to see your results online and you may be given a support worker who will be your main contact during your follow-up care. You may also be invited to a workshop to develop the knowledge, skills and confidence to take care of your health.

Who will I see?

If you have your follow-up appointments at a hospital, you will see a member of your multi-disciplinary team (MDT). This is the team of health professionals involved in your care. You might hear it called your specialist team. You might not see the same person each time but they should have information about you. The team usually includes:

  • a specialist nurse
  • a urologist (a surgeon who specialises in problems with the urinary and reproductive systems)
  • an oncologist (a doctor who specialises in cancer treatments other than surgery, such as radiotherapy)
  • a radiographer (a health professional who specialises in helping to plan and give radiotherapy).

If you have your appointments at your GP surgery, you will see your GP or a practice nurse. If there is any sign of your cancer coming back, they will refer you back to the hospital.

Your main contact (key worker)

After your treatment there will usually be one person who is your main contact for your follow-up care. This might be your specialist nurse, hospital doctor, GP, radiographer or another health professional. They are often called your key worker.

They help coordinate your care, answer your questions, and can help you get information and support. Make sure you know the name of your main contact and how to get in touch with them.

On this page when we talk about your doctor or nurse, we are usually talking about this main contact.

Remember, you can also call our Specialist Nurses for information and support.

What happens at a follow-up appointment?

Discussion with your doctor or nurse

At each appointment, your doctor or nurse will ask how you’ve been since your last appointment.

Tell them about any symptoms or treatment side effects you’ve had, as well as any other problems or concerns. You can tell them how you are feeling emotionally as well as physically. You can also discuss any practical problems you might have, such as problems at work or with day-to-day activities. You may be given a questionnaire about your physical, social, emotional and practical needs. You might hear this called a holistic needs assessment (HNA) form.

Your GP or hospital doctor or nurse can help you deal with side effects, or refer you to someone else who can. For example, if you have problems with leaking urine (incontinence), they might refer you to a continence service. Or if you have problems getting or keeping erections (erectile dysfunction), they can refer you to an erectile dysfunction (ED) service. They can also help you get support for emotional problems, such as feeling anxious or depressed, and practical problems, such as managing your finances.

You might feel embarrassed talking about some of the side effects of treatments, such as erection problems. But remember – doctors and nurses see people with these problems every day, so be as open as you can. They are there to help.

PSA test

The PSA test is a blood test that measures the amount of a protein called prostate specific antigen (PSA) in your blood. You will usually have one done a week or two before your appointment, so that the results are available at your check-up. You will be told when to make an appointment for the test. It might be done at your GP surgery or at hospital, depending on the services in your area.

You may be asked to avoid any vigorous exercise or ejaculating in the 48 hours before a PSA test, as this could cause a temporary rise in your PSA level.

Receiving anal sex or having your prostate stimulated during sex might also raise your PSA level. It might be worth avoiding these activities for a week before a PSA test.

The PSA test is a good way to check whether the treatment was successful at getting rid of your prostate cancer. A continuous rise in your PSA level can be the first sign that the cancer has come back. You can keep a record of your PSA levels in the appointment diary in our booklet, Follow-up after prostate cancer treatment: What happens next?.

Read more about PSA levels after different treatments.

Speak to your doctor or nurse if you think you’ve missed a PSA test, or if you are concerned about your
PSA level.

Tips to get the most from your follow-up appointments

Write down any questions or concerns beforehand

It's easy to forget what you want to say once you’re at your appointment.

Bring someone with you

It can be hard to take everything in at your appointments. Some people find it helpful to take someone with them, to listen and discuss things with later. If your appointment is on the phone, you could ask a friend or family member to listen with you.

Make notes

It can help to write things down during or after your appointment. There’s space for this in the appointment diary in our booklet, Follow-up after prostate cancer treatment: What happens next?

Ask to record your appointment

You could do this using your phone or another recording device. You have the right to record your appointment if you want to because it’s your personal data. But let your doctor or nurse know if you are recording them.

Ask for help

If there is anything bothering you, let your doctor or nurse know.

Ask for copies of any letters

If your appointment is at the hospital, ask for a copy of the letter that is sent to your GP. This will happen automatically at some hospitals. It will help to remind you of what was said at your appointment. If you don't understand the letter, call your main contact at the hospital or contact our Specialist Nurses.

What happens between appointments?

Contact your doctor or nurse if you have any concerns or get any new symptoms or side effects between your follow-up appointments.

It’s important to speak to them if you’re concerned about anything – don’t worry about them being too busy.

You can get support or advice over the telephone, or they might bring forward the date of your next
follow-up appointment.

How long will my follow-up last?

You will have follow-up appointments for some time after your treatment. Exactly how long will depend on your cancer, any side effects of treatment and the services in your area. You will usually have appointments for several years.

After your follow-up appointments finish, you may continue to have PSA tests. Speak to your GP if you have any problems or concerns – they can refer you back to the hospital. Make sure you remind them about your prostate cancer, especially if it’s been a while since you had treatment or a PSA test.

Side effects of treatment

Treatments for prostate cancer can cause side effects, which might carry on after your treatment has finished. Some side effects can even start several months or years after treatment finishes.

Side effects will affect each man differently – you may not get all the possible side effects from your treatment.

Read more about:

Managing side effects

Side effects can affect your day-to-day life, but there are treatments for them, as well as things you can do to manage them yourself. It’s important to speak to your doctor, nurse or GP about them.

If you’re having problems with a side effect, you might have a meeting with your doctor or nurse to work out what support you need. They may refer you to someone who can give you more advice and support. 

Read more about managing the side effects of prostate cancer treatment.

Support to manage side effects

Our Specialist Nurses provide a Sexual Support Service that you may find helpful in coming up with ways to manage some of the side effects of your treatment. They can also provide support if you have fatigue caused by your cancer or its treatments.

Find out more here: 

Sexual support service

Fatigue support

The risk of your cancer coming back

For many men with localised or locally advanced prostate cancer, treatment is successful and gets rid of the cancer. But sometimes not all the cancer is successfully treated, or the cancer may have been more advanced than first thought. If this happens, your cancer may come back – this is known as recurrent prostate cancer.

One of the aims of your follow-up appointments is to check for any signs that your cancer has come back. If your cancer does come back, there are treatments available that aim to control or get rid of the cancer.

Your doctor can’t say for certain whether your cancer will come back. They can only tell you how likely this is.

When your prostate cancer was first diagnosed, your doctor may have talked about the risk of your cancer coming back after treatment. To work out your risk, your doctor will have looked at your PSA level, your Gleason score, the stage of your cancer and your Cambridge Prognostic Group (CPG). If your prostate has been removed, it will have been sent to a laboratory for further tests. This can give a better idea of how aggressive the cancer was and whether it is likely to spread. If you don’t know these details, ask your doctor or nurse.

PSA levels after treatment

A continuous rise in your PSA level can be the first sign that your cancer has come back. This should be picked up by your regular PSA tests.

The exact change in PSA level that suggests your cancer has come back will depend on which treatment you had. Speak to your doctor or nurse about your own situation.

Your PSA level should drop so low that it’s not possible to detect it (less than 0.1 ng/ml) at six to eight weeks after surgery. This is because the prostate, which produces PSA, has been removed. A rise in your PSA level may suggest that you still have some prostate cancer cells.

After radiotherapy or brachytherapy, your PSA should drop to its lowest level (nadir) after 18 months to two years. Your PSA level won’t fall to zero as your healthy prostate cells will continue to produce some PSA.

Your PSA level may actually rise after radiotherapy treatment, and then fall again. This is called ‘PSA bounce’. It could happen up to three years after treatment. It is normal, and doesn’t mean that the cancer has come back.

If your PSA level rises by 2 ng/ml or more above its lowest level, or if it rises for three PSA tests in a row within six months, this could be a sign that your cancer has come back. Your doctor will continue to check your PSA level and will talk to you about further tests and treatment options.

Because HIFU and cryotherapy are relatively new, we don’t know so much about what PSA level can be a sign that your cancer has come back. But your PSA level should fall and then stay low after your treatment. Speak to your doctor or nurse about your own situation.

What symptoms should I look out for?

If your cancer does come back, the first sign is likely to be a rise in your PSA level, rather than any symptoms. And problems will often be side effects of treatment rather than a sign that your cancer has come back.

However, it’s important to let your doctor or nurse know if you do get any new symptoms or side effects, or are worried that your cancer might have come back. If your cancer has come back and has spread from the prostate to other parts of the body, it can cause symptoms, such as extreme tiredness (fatigue), bone pain and problems urinating.

Your doctor or nurse can help find out what might be causing your symptoms and help you manage any side effects. They can also look at your PSA level and do other tests to see whether or not your cancer might have come back.

What other tests might I have?

If your doctor or nurse is concerned about your PSA level or if you have new symptoms that suggest your cancer might have come back, they may recommend that you have some other tests, such as a prostate biopsyMRI scan, CT scanbone scan or PET scan.

Your doctor or nurse will explain these tests to you if you need them, or you can get in touch with our Specialist Nurses for more information.

Common thoughts and feelings

You may feel all sorts of things after you finish treatment. Some men are relieved and feel ready to put the cancer behind them and get back to normal life. But others find it difficult to move on. Adjusting to life after cancer can take time.

For some men, the emotional impact of what they have been through only hits them after they have finished treatment. You might feel angry – for example, angry at what you have been through, or about the side effects of treatment. Or you might feel sad or worried about the future.

Follow-up appointments can also cause different emotions. You might find it reassuring to see the doctor or nurse, or you may find it stressful, particularly in the few days before your appointments.

Worries about your cancer coming back

You may worry about your cancer coming back. This is natural, and will often improve with time. There are things you can do to help manage your concerns, such as finding ways to reduce stress. Breathing exercises and listening to music can help you relax and manage stress. Some people find that it helps to share what they’re thinking with somebody else, like a friend. If you are still struggling, you can get help for stress or anxiety on the NHS – you can refer yourself directly to a psychological therapies service or ask your GP.

If you’re worried about your PSA level or have any new symptoms, speak to your doctor or nurse. If your cancer does come back, you'll be offered further treatment.

Feeling isolated

During follow-up, you might find it difficult seeing your doctor or nurse less often than when you were having treatment. You might miss their regular support and reassurance. Some men say they feel isolated and abandoned when they finish their treatment. Speak to your GP if you have any concerns, or find out who else can help.

Dealing with side effects of treatments

Some men with long-term side effects find they only notice the emotional impact of these once their cancer treatment has finished. Getting support to manage your side effects can help. Our interactive How to manage guides have lots of practical tips to help you manage side effects, including fatigue, sexual side effects, and urinary problems.

Depression and anxiety

Men with prostate cancer may get depressed before or after treatment.

Depression can cause a variety of symptoms from feelings of unhappiness and hopelessness, to losing interest in the things you usually enjoy and feeling very tearful. Many people with depression also feel anxious or worried. These feelings can impact on your life and mean that you feel constantly tired, sleep badly and have no appetite. You may also feel more angry and irritable than before.

If you notice these changes in yourself and they don't go away after a few weeks, speak to your GP, hospital doctor or nurse – there are things that can help.

Regular physical activity can help you deal with feelings of anxiety and depression. Learning ways to relax, such as yoga or meditation, might also help.

You can also talk things through with our Specialist Nurses. If you need to speak to someone immediately, ring the Samaritans.

Read about Mike and Martin’s approaches to life after treatment.

Questions to ask your doctor or nurse

  • How often will I have follow-up appointments and where will they be?
  • What will happen at my appointments?
  • How will I receive my results?
  • Are there any side effects I might develop at a later date?
  • Is there anything I can do myself to manage side effects?
  • What is the risk of my cancer coming back?

References and reviewers

Updated: September 2022 | To be reviewed: November 2023

  • Abdollah F, Sun M, Suardi N, Gallina A, Bianchi M, Tutolo M, et al. Prediction of Functional Outcomes After Nerve-Sparing Radical Prostatectomy: Results of Conditional Survival Analyses. Eur Urol. 2012 Jul;62(1):42–52.
  • Allott EH, Masko EM, Freedland SJ. Obesity and Prostate Cancer: Weighing the Evidence. Eur Urol. 2013 May;63(5):800–9.
  • Anderson CA, Omar MI, Campbell SE, Hunter KF, Cody JD, Glazener CMA. Conservative management for postprostatectomy urinary incontinence. Cochrane Database Syst Rev. 2015;1:CD001843.
  • Ávila M, Patel L, López S, Cortés-Sanabria L, Garin O, Pont À, et al. Patient-reported outcomes after treatment for clinically localized prostate cancer: A systematic review and meta-analysis. Cancer Treat Rev. 2018 May 1;66:23–44.
  • Beard C, Stason WB, Wang Q, Manola J, Dean-Clower E, Dusek JA, et al. Effects of complementary therapies on clinical outcomes in patients being treated with radiation therapy for prostate cancer. Cancer. 2011 Jan 1;117(1):96–102.
  • Berkey FJ. Managing the adverse effects of radiation therapy. Am Fam Physician. 2010 Aug 15;82(4):381–8, 394.
  • Boorjian SA, Eastham JA, Graefen M, Guillonneau B, Karnes RJ, Moul JW, et al. A Critical Analysis of the Long-Term Impact of Radical Prostatectomy on Cancer Control and Function Outcomes. Eur Urol. 2012 Apr;61(4):664–75.
  • Bourke L, Smith D, Steed L, Hooper R, Carter A, Catto J, et al. Exercise for Men with Prostate Cancer: A Systematic Review and Meta-analysis. Eur Urol. 2016 Apr;69(4):693–703.
  • Cao Y, Ma J. Body Mass Index, Prostate Cancer-Specific Mortality, and Biochemical Recurrence: a Systematic Review and Meta-analysis. Cancer Prev Res (Phila Pa). 2011 Jan 13;4(4):486–501.
  • Chen KW, Berger CC, Manheimer E, Forde D, Magidson J, Dachman L, et al. Meditative therapies for reducing anxiety: a systematic review and meta-analysis of randomized controlled trials. Depress Anxiety. 2012 Jul;29(7):545–62.
  • Chen LN, Suy S, Uhm S, Oermann EK, Ju AW, Chen V, et al. Stereotactic body radiation therapy (SBRT) for clinically localized prostate cancer: the Georgetown University experience. Radiat Oncol Lond Engl. 2013;8:58.
  • Chipperfield K, Brooker J, Fletcher J, Burney S. The impact of physical activity on psychosocial outcomes in men receiving androgen deprivation therapy for prostate cancer: A systematic review. Health Psychol. 2014;33(11):1288–97.
  • Clavell-Hernandez J, Wang R. Penile rehabilitation following prostate cancer treatment: review of current literature. Asian J Androl. 2015;17(6):916.
  • Corner J, Wagland R, Glaser A, Richards SM. Qualitative analysis of patients’ feedback from a PROMs survey of cancer patients in England. BMJ Open. 2013 Jan 1;3(4).
  • Crook J. The role of brachytherapy in the definitive management of prostate cancer. Cancer/Radiothérapie. 2011 Jun;15(3):230–7.
  • Darwis NDM, Oike T, Kubo N, Gondhowiardjo SA, Ohno T. Characteristics of PSA Bounce after Radiotherapy for Prostate Cancer: A Meta-Analysis. Cancers. 2020 Aug 5;12(8):2180.
  • Davies NJ, Batehup L, Thomas R. The role of diet and physical activity in breast, colorectal, and prostate cancer survivorship: a review of the literature. Br J Cancer. 2011 Nov 8;105:S52–73.
  • Discacciati A, Orsini N, Wolk A. Body mass index and incidence of localized and advanced prostate cancer--a dose-response meta-analysis of prospective studies. Ann Oncol. 2012 Jan 6;23(7):1665–71.
  • Evangelista L, Briganti A, Fanti S, Joniau S, Reske S, Schiavina R, et al. New Clinical Indications for 18 F/ 11 C-choline, New Tracers for Positron Emission Tomography and a Promising Hybrid Device for Prostate Cancer Staging: A Systematic Review of the Literature. Eur Urol. 2016 Jul;70(1):161–75.
  • Fridriksson JÖ, Folkvaljon Y, Nilsson P, Robinson D, Franck-Lissbrant I, Ehdaie B, et al. Long-term adverse effects after curative radiotherapy and radical prostatectomy: population-based nationwide register study. Scand J Urol. 2016 Sep 2;50(5):338–45.
  • Gaither TW, Awad MA, Osterberg EC, Murphy GP, Allen IE, Chang A, et al. The Natural History of Erectile Dysfunction After Prostatic Radiotherapy: A Systematic Review and Meta-Analysis. J Sex Med. 2017 Sep 1;14(9):1071–8.
  • Galgano SJ, Valentin R, McConathy J. Role of PET imaging for biochemical recurrence following primary treatment for prostate cancer. Transl Androl Urol. 2018 Sep;7(S4):S462–76.
  • Gao L, Yang L, Qian S, Tang Z, Qin F, Wei Q, et al. Cryosurgery would be An Effective Option for Clinically Localized Prostate Cancer: A Meta-analysis and Systematic Review. Sci Rep [Internet]. 2016 Jul [cited 2017 Aug 22];6(1). Available from:
  • Gardner JR, Livingston PM, Fraser SF. Effects of Exercise on Treatment-Related Adverse Effects for Patients With Prostate Cancer Receiving Androgen-Deprivation Therapy: A Systematic Review. J Clin Oncol. 2014 Feb 1;32(4):335–46.
  • Gaztañaga M, Crook J. Interpreting a rising prostate-specific antigen after brachytherapy for prostate cancer: Rising PSA after brachytherapy. Int J Urol. 2013 Feb;20(2):142–7.
  • Gerdtsson A, Poon JB, Thorek DL, Mucci LA, Evans MJ, Scardino P, et al. Anthropometric Measures at Multiple Times Throughout Life and Prostate Cancer Diagnosis, Metastasis, and Death. Eur Urol. 2015 Dec;68(6):1076–82.
  • Goyal M, Singh S, Sibinga EMS, Gould NF, Rowland-Seymour A, Sharma R, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med. 2014 Mar;174(3):357–68.
  • Haseen F, Murray LJ, Cardwell CR, O’Sullivan JM, Cantwell MM. The effect of androgen deprivation therapy on body composition in men with prostate cancer: Systematic review and meta-analysis. J Cancer Surviv. 2010 Jun 1;4(2):128–39.
  • Hechtman LM. Clinical Naturopathic Medicine [Internet]. Harcourt Publishers Group (Australia); 2014 [cited 2015 Jul 21]. 1610 p. Available from:
  • Henson CC, Burden S, Davidson SE, Lal S. Nutritional interventions for reducing gastrointestinal toxicity in adults undergoing radical pelvic radiotherapy. Cochrane Database Syst Rev [Internet]. 2013 [cited 2014 Nov 18];(11). Available from:
  • Ho T, Gerber L, Aronson WJ, Terris MK, Presti JC, Kane CJ, et al. Obesity, Prostate-Specific Antigen Nadir, and Biochemical Recurrence After Radical Prostatectomy: Biology or Technique? Results from the SEARCH Database. Eur Urol. 2012 Nov;62(5):910–6.
  • Hu MB, Xu H, Bai PD, Jiang HW, Ding Q. Obesity has multifaceted impact on biochemical recurrence of prostate cancer: a dose-response meta-analysis of 36,927 patients. Med Oncol Northwood Lond Engl. 2014 Feb;31(2):829.
  • Keilani M, Hasenoehrl T, Baumann L, Ristl R, Schwarz M, Marhold M, et al. Effects of resistance exercise in prostate cancer patients: a meta-analysis. Support Care Cancer. 2017 Jun 10;
  • Keogh JWL, MacLeod RD. Body Composition, Physical Fitness, Functional Performance, Quality of Life, and Fatigue Benefits of Exercise for Prostate Cancer Patients: A Systematic Review. J Pain Symptom Manage. 2012 Jan;43(1):96–110.
  • Keto CJ, Aronson WJ, Terris MK, Presti JC, Kane CJ, Amling CL, et al. Obesity is associated with castration-resistant disease and metastasis in men treated with androgen deprivation therapy after radical prostatectomy: results from the SEARCH database. BJU Int. 2011;110(4):492–8.
  • Kilminster S, Müller S, Menon M, Joseph JV, Ralph DJ, Patel HRH. Predicting erectile function outcome in men after radical prostatectomy for prostate cancer. BJU Int. 2011;110(3):422–6.
  • Kishan A, Kupelian P. Late rectal toxicity after low-dose-rate brachytherapy: incidence, predictors, and management of side effects. Brachytherapy. 2014;14(2):148–59.
  • Klein LT, Lowe FC. The effects of prostatic manipulation on prostate-specific antigen levels. Urol Clin North Am. 1997 May;24(2):293–7.
  • Koch L, Jansen L, Brenner H, Arndt V. Fear of recurrence and disease progression in long-term (≥5 years) cancer survivors-a systematic review of quantitative studies. Psychooncology. 2013 Jan;22(1):1–11.
  • Langston B, Armes J, Levy A, Tidey E, Ream E. The prevalence and severity of fatigue in men with prostate cancer: a systematic review of the literature. Support Care Cancer Off J Multinatl Assoc Support Care Cancer. 2013 Jun;21(6):1761–71.
  • Larkin D, Lopez V, Aromataris E. Managing cancer-related fatigue in men with prostate cancer: A systematic review of non-pharmacological interventions. Int J Nurs Pract. 2014 Oct;20(5):549–60.
  • Levinson AW, Lavery HJ, Ward NT, Su LM, Pavlovich CP. Is a return to baseline sexual function possible? An analysis of sexual function outcomes following laparoscopic radical prostatectomy. World J Urol. 2010 Nov 24;29(1):29–34.
  • Lin PH, Aronson W, Freedland SJ. Nutrition, dietary interventions and prostate cancer: the latest evidence. BMC Med. 2015 Jan 8;13:3.
  • Menichetti J, Villa S, Magnani T, Avuzzi B, Bosetti D, Marenghi C, et al. Lifestyle interventions to improve the quality of life of men with prostate cancer: A systematic review of randomized controlled trials. Crit Rev Oncol Hematol. 2016 Dec;108:13–22.
  • Michalski JM, Moughan J, Purdy J, Bosch W, Bruner DW, Bahary JP, et al. Effect of Standard vs Dose-Escalated Radiation Therapy for Patients With Intermediate-Risk Prostate Cancer: The NRG Oncology RTOG 0126 Randomized Clinical Trial. JAMA Oncol. 2018 Jun 1;4(6):e180039–e180039.
  • Michalski JM, Yan Y, Watkins-Bruner D, Bosch WR, Winter K, Galvin JM, et al. Preliminary toxicity analysis of 3-dimensional conformal radiation therapy versus intensity modulated radiation therapy on the high-dose arm of the Radiation Therapy Oncology Group 0126 prostate cancer trial. Int J Radiat Oncol Biol Phys. 2013 Dec 1;87(5):932–8.
  • Mishra SI, Scherer RW, Geigle PM, Berlanstein DR, Topaloglu O, Gotay CC, et al. Exercise interventions on health-related quality of life for cancer survivors. Cochrane Database Syst Rev. 2012;8:CD007566.
  • Mohamad H, McNeill G, Haseen F, N’Dow J, Craig LCA, Heys SD. The Effect of Dietary and Exercise Interventions on Body Weight in Prostate Cancer Patients: A Systematic Review. Nutr Cancer. 2015 Jan 2;67(1):43–60.
  • Mohammed N, Kestin L, Ghilezan M, Krauss D, Vicini F, Brabbins D, et al. Comparison of acute and late toxicities for three modern high-dose radiation treatment techniques for localized prostate cancer. Int J Radiat Oncol Biol Phys. 2012 Jan 1;82(1):204–12.
  • Morton GC. The emerging role of high-dose-rate brachytherapy for prostate cancer. Clin Oncol. 2005 Jun;17(4):219–27.
  • Mottet N, Cornford P, van der Bergh RCN. EAU Guidelines on Prostate Cancer. European Association of Urology; 2022.
  • Mottet N, Prayer-Galetti T, Hammerer P, Kattan MW, Tunn U. Optimizing outcomes and quality of life in the hormonal treatment of prostate cancer. BJU Int. 2006 Jul;98(1):20–7.
  • National Institute for Health and Care Excellence. Prostate cancer: diagnosis and management. 2021.
  • National Institute for Health and Clinical Excellence. Focal therapy using cryoablation for localised prostate cancer. NICE interventional procedure guidance 423 [Internet]. 2012. Available from:
  • National Institute for Health and Clinical Excellence. High dose rate brachytherapy in combination with external-beam radiotherapy for localised prostate cancer. Interventional procedure guidance 174. 2006;
  • Newby TA, Graff JN, Ganzini LK, McDonagh MS. Interventions that may reduce depressive symptoms among prostate cancer patients: a systematic review and meta-analysis. Psychooncology. 2015 Dec;24(12):1686–93.
  • Nguyen PL, Alibhai SMH, Basaria S, D’Amico AV, Kantoff PW, Keating NL, et al. Adverse Effects of Androgen Deprivation Therapy and Strategies to Mitigate Them. Eur Urol. 2015 May;67(5):825–36.
  • NHS website. PET scans [Internet]. [cited 2022 Aug 23]. Available from:
  • NHS. Clinical depression [Internet]. 2016. Available from:
  • O’Brien R, Rose PW, Campbell C, Weller D, Neal RD, Wilkinson C, et al. Experiences of follow-up after treatment in patients with prostate cancer: a qualitative study. BJU Int. 2010 Oct;106(7):998–1003.
  • Parsons BA, Evans S, Wright MP. Prostate cancer and urinary incontinence. Maturitas. 2009;63(4):323–8.
  • Patel S, Demanes DJ, Ragab O, Zhang M, Veruttipong D, Nguyen K, et al. High-dose-rate brachytherapy monotherapy without androgen deprivation therapy for intermediate-risk prostate cancer. Brachytherapy. 2017 Mar;16(2):299–305.
  • Peinemann F, Grouven U, Hemkens LG, Bartel C, Borchers H, Pinkawa M, et al. Low-dose rate brachytherapy for men with localized prostate cancer. The Cochrane Collaboration, editor. Cochrane Database Syst Rev. 2011 Jul 6;
  • Pettersson A, Johansson B, Persson C, Berglund A, Turesson I. Effects of a dietary intervention on acute gastrointestinal side effects and other aspects of health-related quality of life: A randomized controlled trial in prostate cancer patients undergoing radiotherapy. Radiother Oncol. 2012 Jun;103(3):333–40.
  • Ralph S, Richardson C. Developing UK guidance on how long men should abstain from receiving anal sex before, during, and after investigations and treatments for prostate cancer [MClin Res dissertation]. University of Manchester; 2018.
  • Ramsay CR, Adewuyi TE, Gray J, Hislop J, Shirley MD, Jayakody S, et al. Ablative therapy for people with localised prostate cancer: a systematic review and economic evaluation. Health Technol Assess. 2015 Jul;19(49):1–490.
  • Richman EL, Kenfield SA, Stampfer MJ, Paciorek A, Carroll PR, Chan JM. Physical Activity after Diagnosis and Risk of Prostate Cancer Progression: Data from the Cancer of the Prostate Strategic Urologic Research Endeavor. Cancer Res. 2011 May 24;71(11):3889–95.
  • Schmid MP, Pötter R, Bombosch V, Sljivic S, Kirisits C, Dörr W, et al. Late gastrointestinal and urogenital side-effects after radiotherapy – Incidence and prevalence. Subgroup-analysis within the prospective Austrian–German phase II multicenter trial for localized prostate cancer. Radiother Oncol. 2012 Jul;104(1):114–8.
  • Sharifi N, Gulley JL, Dahut WL. An Update on Androgen Deprivation Therapy for Prostate Cancer. Endocr Relat Cancer. 2010 Dec;17(4):R305–15.
  • Simon NI, Parker C, Hope TA, Paller CJ. Best Approaches and Updates for Prostate Cancer Biochemical Recurrence. Am Soc Clin Oncol Educ Book. 2022 Jul;(42):352–9.
  • Sopko NA, Burnett AL. Erection rehabilitation following prostatectomy — current strategies and future directions. Nat Rev Urol. 2016 Mar 15;13(4):216–25.
  • Teleni L, Chan RJ, Chan A, Isenring EA, Vela I, Inder WJ, et al. Exercise improves quality of life in androgen deprivation therapy-treated prostate cancer: systematic review of randomised controlled trials. Endocr Relat Cancer. 2016 Jan 2;23(2):101–12.
  • Tillisch K. Complementary and alternative medicine for functional gastrointestinal disorders. Gut. 2006 May 1;55(5):593–6.
  • Wang LS, Murphy CT, Ruth K, Zaorsky NG, Smaldone MC, Sobczak ML, et al. Impact of obesity on outcomes after definitive dose-escalated intensity-modulated radiotherapy for localized prostate cancer. Cancer. 2015 Sep 1;121(17):3010–7.
  • Watts S, Leydon G, Birch B, Prescott P, Lai L, Eardley S, et al. Depression and anxiety in prostate cancer: a systematic review and meta-analysis of prevalence rates. BMJ Open. 2014 Mar 13;4(3):e003901–e003901.
  • Wedlake LJ, Shaw C, Whelan K, Andreyev HJN. Systematic review: the efficacy of nutritional interventions to counteract acute gastrointestinal toxicity during therapeutic pelvic radiotherapy. Aliment Pharmacol Ther. 2013 Jun;37(11):1046–56.
  • Wilkins D. Untold problems: a review of the essential issues in the mental health of men and boys [Internet]. Men’s health Forum; 2010. Available from:
  • Wolin KY, Luly J, Sutcliffe S, Andriole GL, Kibel AS. Risk of Urinary Incontinence Following Prostatectomy: The Role of Physical Activity and Obesity. J Urol. 2010 Feb;183(2):629–33.
  • World Cancer Research Fund International. Continuous Update Project report: Diet, Nutrition, Physical Activity and Prostate Cancer [Internet]. 2014. Available from:
  • Zelefsky MJ, Levin EJ, Hunt M, Yamada Y, Shippy AM, Jackson A, et al. Incidence of late rectal and urinary toxicities after three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for localized prostate cancer. Int J Radiat Oncol. 2008;70(4):1124–9.


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