Risk of Dying of Prostate Cancer in Men With a Rising PSA After Radical Prostatectomy

This nomogram can be used by patients to estimate the risk of dying of prostate cancer if their cancer recurs, signaled by a rising PSA, after radical prostatectomy. The nomogram predicts the likelihood, in a man initially treated with surgery, that he will die of prostate cancer five, ten, and 15 years from the time his PSA begins to rise.

The information used to build this prediction tool was based on patients treated from 1987 to 2011. Since then, treatment for men with advanced prostate cancer has improved, so the risk of dying of the disease in the future may be less than estimated by this tool. Results produced by this tool are based on studies conducted at large research institutions with surgeons who perform a high volume of prostate cancer procedures. All results must be understood in the context of each patient’s specific treatment plan. Patients and caregivers using this tool should discuss the result with the patient’s physician.

To gather the information required to use this nomogram, use our worksheet.

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Disqualifying Treatments

If you received either hormone or radiation therapy for prostate cancer either before your surgery (radical prostatectomy) or after your surgery but before your PSA began to rise — if you answer “yes” to any of the following four questions — the results of this nomogram will not apply to you.

Before Surgery

ng/mL (0.1 to 100)

After Surgery

What is extracapsular extension?
Extracapsular extension is cancer that extends into or outside the prostate “capsule” or organ, as determined from the radical prostatectomy pathology report.
What are pelvic lymph nodes?
The pelvic lymph nodes are small glands that filter fluid made in the prostate; they can be an early site of prostate cancer spread.
What are seminal vesicles?
The seminal vesicles are glands that help to produce semen.
What are positive surgical margins?
Surgical margins are positive if cancer cells are present at the edges of the removed prostate.

At Recurrence

years (35 to 85)
months (1 to 180)
Note: The date of prostate cancer biochemical recurrence after radical prostatectomy is one of the following: the date of the third successive PSA increase (final value greater than 0.2 ng/mL), the date of the first PSA value of 0.4 ng/mL or greater, or the date additional therapy was administered because of any detectable PSA level above 0.
ng/mL (0.2 to 100)
Note: PSA at biochemical recurrence is the PSA measurement at the time at which the criteria for biochemical recurrence were fulfilled: three successive PSA rises (final value greater than 0.2 ng/mL), single PSA of 0.4 ng/mL or greater, or additional therapy administered for detectable PSA greater than 0.1 ng/mL.
What is biochemical recurrence?
Biochemical recurrence refers to a rise in the blood level of PSA (prostate-specific antigen) in prostate cancer patients after treatment with surgery or radiation. It may mean that the cancer has come back. Also called biochemical relapse and PSA failure.
months (0.01 to 120)
Note: If you do not know your PSA doubling time, use our PSA doubling time calculator or leave this blank.
What is PSA doubling time (PSADT)?
PSA doubling time (PSADT) is the period of time it takes for a man’s PSA level to double in value.