Salvage Radiation Therapy


Our salvage radiation therapy nomogram predicts whether a recurrence of prostate cancer after radical prostatectomy can be treated successfully with salvage radiation therapy (external-beam radiation given after the prostate cancer returns). It calculates the probability that the cancer will be controlled and PSA level undetectable six years after salvage therapy. You can use this nomogram for applicable results if your post-radical prostatectomy serum PSA level was at first undetectable (less than 0.05 ng/mL) and then rose steadily, indicating a recurrence.

Results produced by this tool are based on studies conducted at large research institutions with physicians 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.

Enter Your Information

All fields are required unless noted optional

General Information

Important: If your PSA level never decreased to an undetectable level following radical prostatectomy, the results of this nomogram will not apply to you.

ng/mL (0.1 to 100)
What is PSA?
PSA (prostate-specific antigen) is a protein made by the prostate gland and found in the blood. PSA blood levels may be higher than normal in men who have prostate cancer, benign prostatic hyperplasia (BPH), or infection or inflammation of the prostate gland.
ng/mL (0.1 to 100)
PSA doubling time should be calculated from all PSA values obtained over the last 12 months, or all values following radical prostatectomy, beginning at the point at which PSA had reached its lowest level. months (0.01 to 120)
months (0 to 72)

What is your Gleason score?

How are Gleason patterns/scores determined?
Physicians characterize the aggressiveness of prostate cancer using the Gleason scoring system, which provides an estimate of the cancer’s potential to grow and spread to other parts of the body. The pathologist determines the Gleason pattern based on how closely the cells of the gland resemble those of a normal prostate. Once the prostate is removed during surgery, a pathologist examines the prostate and assigns a pattern to the most common tumor, known as the primary Gleason pattern, and a second pattern to the next most common tumor, known as the secondary Gleason pattern. The two patterns are added together to get a Gleason score.
The score will be automatically calculated from the sum of the primary and secondary Gleason pattern numbers or can be entered here as a single number if the primary and secondary Gleason pattern numbers are unknown.
If you enter this score manually
If you don’t know your primary and secondary Gleason grade, but only the total score, you can enter it directly yourself. The result will be slightly less accurate but still close to the true value.

Prostatectomy Pathology Report Details

Were your surgical margins positive?
What are positive surgical margins?
Surgical margins are positive if cancer cells are present at the edges of the removed prostate.
Was there extracapsular extension?
What is extracapsular extension?
Extracapsular extension is cancer that extends into or outside the prostate "capsule" or organ, indicated on the post-radical prostatectomy pathology report.
Was cancer present in the seminal vesicles?
What are seminal vesicles?
Seminal vesicles are glands that help to produce semen. They are a frequent site of prostate cancer and are typically removed during a radical prostatectomy.
Was cancer present in the pelvic lymph nodes?
What are pelvic lymph nodes?
Lymph nodes are small glands that filter fluid made in the prostate; they can be an early site of prostate cancer spread.

Additional Treatment Information

Did your PSA value obtained after radical prostatectomy remain elevated?
(In other words, did the PSA value never decrease to an undetectable level?)
Gy (10 to 100)
Enter a radiation dose value between 10 and 100 Gy. If you are not sure, leave as 65 Gy.
Does your radiation oncologist plan to give you hormone therapy before or along with salvage radiation therapy?