Should asymptomatic progression following definitive local treatment for prostate cancer be treated?

Asymptomatic progression following definitive therapy for prostate cancer can take the form of a detectable prostate-specific antigen (PSA) or local recurrence following radical prostatectomy or a rising PSA or palpable recurrence following radiotherapy. Options for treatment include hormonal therapy, radiotherapy, salvage surgery, and experimental therapies. Although such forms of treatment have known effects on intermediate endpoints, such as reduction of PSA, the overall effect on survival and quality of life is uncertain.