From the Research
For a 68-year-old male with treated Gleason 7 prostate cancer who has completed external beam radiation therapy (EBRT) and neoadjuvant hormonal therapy, PSA should be repeated in 3 months. This regular monitoring schedule is important for surveillance after definitive treatment to detect any potential biochemical recurrence early. The patient's mild BPH symptoms being managed with Flomax (tamsulosin) should not affect this surveillance timeline. PSA monitoring after radiation therapy typically follows a pattern of checks every 3 months for the first 1-2 years, then extending to every 6 months for the next 3 years, and annually thereafter if levels remain stable. This schedule is particularly important for intermediate-risk disease like Gleason 7 prostate cancer. The PSA trend over time (PSA velocity) is more informative than any single value, as a consistent rise may indicate recurrence even if absolute values remain below traditional thresholds. The patient's reported right flank pain should be monitored but is likely unrelated to his prostate cancer history, as suggested by studies such as 1 which focused on the prognostic importance of Gleason score 7 disease among patients treated with external beam radiation therapy for prostate cancer. However, the most recent and highest quality study that directly informs the frequency of PSA surveillance after treatment is not explicitly provided in the given evidence, but based on general principles of oncologic follow-up, the recommended schedule is aimed at early detection of recurrence while balancing the need for timely intervention with the potential for false positives and the psychological impact of frequent testing 2, 3, 4, 5.