Follow up after prostate cancer treatment

After treatment for prostate cancer, you have regular check ups. You usually have these at the hospital with your doctor or specialist nurse (CNS). You also have tests including blood tests to check your PSA level. 

Why you have follow up appointments

You usually have follow up appointments to check how you are and see whether you have any problems or worries. The appointments also give you the chance to raise any concerns you have about your progress.

How often are my follow up appointments?

How often you see your specialist depends on:

• how you are feeling
• the type of treatment you have had

Ask your doctor or specialist nurse how often your follow up appointments are likely to be. 

Treatment to cure your cancer

Your first follow up appointment is usually at least 6 weeks after treatment. Then, your follow up will be every 6 months for 2 to 5 years. And at least once a year after that.

To begin with, you usually go for check ups at the hospital outpatients. After 2 years, you might have your appointments with your GP. Instead of seeing the doctor in a clinic, you might be able to have a telephone consultation. 

In some hospitals, you might be able to have your PSA test done at your GP. Your doctor and clinical nurse specialist will then monitor the results and contact you if there is a problem. 

Monitoring your cancer

If the doctors are monitoring your cancer with watchful waiting, then you have check ups at least once a year at your GP. With active surveillance, you have check ups every 6 months with your specialist doctor. 

Metastatic or advanced prostate cancer

Metastatic prostate cancer is cancer that began in the prostate and has spread to another part of the body. You might see the doctor more often if you have metastatic prostate cancer. This depends on your symptoms and what treatment you are having.

What happens?

Your doctor or nurse specialist examines you at each appointment. They ask how you are feeling, whether you have had any symptoms or side effects, and if anything is worrying you. You might also have tests at some visits.

You usually have a blood test to monitor your prostate specific antigen (PSA) level.

Depending on your PSA level, you might have a prostate examination. The doctor puts a gloved finger into your back passage (digital rectal examination).

You might also have a CT, MRI or bone scan.

Between appointments

If you are worried or notice any new symptoms between your appointments, let your doctor or nurse know as soon as possible. You don't have to wait until the next appointment.

Many people find their check ups quite worrying. A hospital appointment can bring back any anxiety you had about your cancer.

It can help to tell someone close to you how you’re feeling. Sharing your worries can mean they don’t seem so overwhelming. Many people find it helpful to have counselling after cancer treatment.

You can also find people to share experiences with by using our online forum, Cancer Chat. 

Patient initiated follow up (PIFU)

Patient initiated follow up (PIFU) is a way of running check ups. This system leaves it to you to take the lead in arranging to see your doctor or specialist nurse. You might also hear this called open access follow up (OAFU).

When you first finish treatment, your hospital arranges your appointments. But once your doctors are happy with your progress you can arrange them yourself. You can do this as often as you feel you need to.

You might want to make an appointment if you:

• have noticed a change in your body that worries you

• feel it is time you had a check up, even though you don't have any particular worries

In some situations, your specialist will ask you to book in for a particular test every so often.

This system means you can organise appointments to suit your own health needs. It also means that clinics aren’t full of people who might not need to see their doctor. This helps the hospital to keep waiting times short, so you can get an appointment quickly when you need one.