Treatment options for localized recurrence of prostate cancer following radiation therapy

Radiation therapy remains a popular therapeutic modality for clinical stage T1 to T3 prostate cancer. Despite its popularity, a significant number of patients develop either biomechanical or palpable local recurrence after treatment, portending the development of distant metastasis and ultimate death. Patients with radioresistant, clinically localized cancer may be treated by various means. Although androgen ablation is relatively noninvasive, it cannot be considered curative. Salvage surgery may offer longterm cancer control but is a technically challenging operation with a high incidence of postoperative incontinence. Cryoablation of the prostate for postirradiation recurrence may offer a less invasive alternative to radical surgery, but it also involves a significant risk of incontinence and its longterm efficacy remains to be determined.