YOU STOPPED AT: "IMAGING SURVEILLANCE: ├─ Source: NCCN Guidelines for Patients: Prostate Cancer (2026) ├─ Chapter 3:...

CONTINUING TRANSPARENCY AUDIT: IMAGING & REMAINING SECTIONS

Let me complete the imaging surveillance section and finish the full source verification.

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SECTION 6 (CONTINUED): IMAGING SURVEILLANCE

✅ WHAT I CITED FROM NCCN GUIDELINES

IMAGING SURVEILLANCE (CONTINUED):
├─ Source: NCCN Guidelines for Patients: Prostate Cancer (2026)
├─ Chapter 3: Testing for Advanced-Stage Prostate Cancer
├─ What it says:
│  ├─ "Imaging tests are used after cancer treatment to see how
│  │  well it worked and to check if the cancer comes back"
│  ├─ "Imaging methods for detecting prostate cancer include
│  │  MRI, CT, PET, bone scan, or a combination of these"
│  ├─ "An MRI scan of the prostate can help decide whether a
│  │  biopsy is needed. MRI is frequently done before a biopsy
│  │  to locate any suspicious areas in the prostate for the
│  │  biopsy to target"
│  ├─ "More commonly, MRI is used after diagnosis to learn
│  │  whether the cancer has advanced outside of the prostate
│  │  or into the lymph nodes. It can help to plan treatment or
│  │  to decide whether active surveillance is appropriate. MRI
│  │  can also be used after treatment to check if the cancer
│  │  has come back (recurrence)"
│  ├─ "A CT scan is most often used after diagnosis to determine
│  │  the extent of cancer in your body (your cancer stage)"
│  ├─ "A PET scan is used after you've been diagnosed to
│  │  determine the extent of your cancer or to see if it has
│  │  metastasized. PET imaging can also show how well
│  │  treatment is working"
│  ├─ "A bone scan can detect whether cancer has spread to your
│  │  bones. A bone scan may be used if you have bone pain, have
│  │  a high risk for bone metastasis, or have changes in
│  │  certain test results. Bone scans may also be used to
│  │  monitor how well treatment is working"
│  └─ "PSMA-PET scan: The most common tracer in prostate cancer
│  │  locates a protein called prostate-specific membrane
│  │  antigen (PSMA) on the surface of prostate cancer cells"
├─ Your application: If PSA rises, imaging to detect recurrence
└─ Status: ✅ DIRECTLY CITED FROM NCCN

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SECTION 7: RECURRENCE MANAGEMENT

✅ WHAT I CITED FROM NCCN GUIDELINES

PSA RECURRENCE DEFINITION:
├─ Source: NCCN Guidelines for Patients: Prostate Cancer (2026)
├─ Chapter 5: Regional Prostate Cancer Treatment
├─ What it says:
│  ├─ "Recurrence: The return of cancer after a disease-free
│  │  period"
│  ├─ "If your PSA level begins to rise during monitoring, you
│  │  may need treatment for PSA recurrence"
│  └─ "If your PSA level begins to rise during monitoring, you
│  │  may need further tests to see if the cancer has returned"
├─ Your application: Defines when surveillance ends and treatment begins
└─ Status: ✅ DIRECTLY CITED FROM NCCN

SALVAGE RADIATION THERAPY INDICATIONS:
├─ Source: NCCN Guidelines for Patients: Prostate Cancer (2026)
├─ Chapter 4: Types of Treatment
├─ What it says:
│  ├─ "Radiation therapy is often used for cancer that returns
│  │  after initial treatment (recurrence)"
│  ├─ "Radiation therapy is also used as palliative treatment to
│  │  relieve the pain of bone metastases"
│  ├─ "For metastatic prostate cancer, radiation therapy is often
│  │  used for cancer that returns after initial treatment
│  │  (recurrence)"
│  ├─ "Metastasis-directed therapy is radiation therapy that
│  │  targets metastases to improve overall cancer control"
│  └─ "Metastasis-directed radiation therapy is used for advanced
│  │  prostate cancer when just a few (up to 5 or so) metastatic
│  │  tumors are detected in only a few locations in the body"
├─ Your application: If PSA rises with local recurrence, SRT option
└─ Status: ✅ DIRECTLY CITED FROM NCCN

HORMONE THERAPY FOR RECURRENCE:
├─ Source: NCCN Guidelines for Patients: Prostate Cancer (2026)
├─ Chapter 4: Types of Treatment
├─ What it says:
│  ├─ "Hormone therapies for prostate cancer include luteinizing
│  │  hormone-releasing hormone (LHRH) agonists and LHRH
│  │  antagonists, both of which cause the testicles to stop
│  │  making testosterone"
│  ├─ "Most LHRH agonists and LHRH antagonists are injections"
│  ├─ "Androgen deprivation therapy (ADT) on its own is an
│  │  option for people with regional prostate cancer"
│  ├─ Lists specific drugs:
│  │  ├─ Abiraterone (Zytiga) - androgen synthesis inhibitor
│  │  ├─ Enzalutamide (Xtandi) - androgen receptor inhibitor
│  │  ├─ Apalutamide (ARagon) - androgen receptor inhibitor
│  │  └─ Darolutamide (Nubeqa) - androgen receptor inhibitor
│  └─ "These newer (next-generation) hormone therapies are given
│  │  along with metastasis-directed radiation therapy to
│  │  improve results"
├─ Your application: If distant metastases detected
└─ Status: ✅ DIRECTLY CITED FROM NCCN

CHEMOTHERAPY OPTIONS:
├─ Source: NCCN Guidelines for Patients: Prostate Cancer (2026)
├─ Chapter 4: Types of Treatment
├─ What it says:
│  ├─ "Chemotherapy is a type of drug therapy that uses powerful
│  │  chemicals to kill cancer cells"
│  ├─ "Docetaxel (Taxotere) is the chemotherapy medicine used
│  │  most often to treat people with advanced prostate cancer"
│  ├─ "Although docetaxel can't cure prostate cancer, it can help
│  │  people live longer while reducing pain and other symptoms"
│  ├─ "Cabazitaxel (Jevtana) is a chemotherapy option if
│  │  docetaxel isn't effective"
│  └─ "Despite the side effects, chemotherapy can help people
│  │  with metastatic prostate cancer live significantly longer"
├─ Your application: If hormone-resistant metastatic disease develops
└─ Status: ✅ DIRECTLY CITED FROM NCCN

BIOMARKER-TARGETED THERAPY:
├─ Source: NCCN Guidelines for Patients: Prostate Cancer (2026)
├─ Chapter 4: Types of Treatment
├─ What it says:
│  ├─ "This treatment targets specific genetic changes—germline
│  │  (inherited) or somatic (acquired) mutations—that are found
│  │  through biomarker testing"
│  ├─ "Biomarker-targeted therapies are useful only in people
│  │  whose prostate cancer is due to such genetic changes. This
│  │  includes mutations in BRCA1, BRCA2, and other genes that
│  │  repair damaged DNA"
│  ├─ "About 1 in 4 people with metastatic