Surgery or Radiotherapy? Decision made!

Oh yes. 

I am impressed by your post treatment  recovery and your unhindered fitness.  A positive tale which is so different to what is often posted on sites like this.  A beacon for us all.

Well done.

Thanks Dedalus - that’s why I add to my thread : the good news as well as the bad.

oh, and I notice Seamus47 has liked this post too.  His is one of the stories that helped me decide on my treatment pathway: I’ve just re-read his bio , it is textbook.  Well done again NHS!

AW

An interesting read (taken from another site):

RT usually halves or quarters PSA soon after the treatment finishes, but continues to have a reducing effect for up to 3 years, although again this will be masked by the HT. RT doesn't immediately kill all the cancer cells, but you hope it damages them enough that they can no longer reproduce, so the cancer is no longer malignant. Those remaining cancer cells then die of old age over about 3 years (and the HT helps keep them dormant during that time). During this time while the cells are dying, PSA drops slowly, but you can get PSA bounces which we think are periods of high activity by the immune system mopping up the cancer cells. However, this isn't usually visible if you are on HT at that time as HT masks it. The RT reduction is the long term effect you hope to see after the HT wears off.

When the HT wears off and your Testosterone returns, your PSA will rise, because you still have a prostate and it will still have non-cancer cells in it which produce PSA. (The RT aims to only kill the cancer cells, not the whole prostate.) You are considered OK if the PSA doesn't rise more than 2.0 above your lowest reading (i.e. if 0.1 is your lowest reading, you're OK unless it rises above 2.1).

RT also helps to mop up micro-mets - any mets which were too small to show on scans including any which were out of the RT treatment field. Exactly how this works isn't known for sure, but if you take out the mothership cancer via brachytherapy or EBRT, and you have continuing HT for a while, the stats would suggest micro-mets are likely to die too, as they may have been relying on signalling/chemicals from the large tumours which they were too small to make themselves.

AW

An interesting summary.  Do you have a link to the research paper?

It’s actually from a very knowledgeable guy called Andy62 (a fellow Brachy Boost patient) who I follow on the PCUK blog site. 

Pleased to hear you are getting back to the ‘ alpine wandering’ AW . Thanks for this article. Looks really interesting!

Thank you AW. It is an informative article. Husband is starting RT ends of April so hopefully will do the job.

I read you are backing to Wondering and guiding the mountains. Amazing job and please keep in touch.

Best wishes

Dafna

Very interesting David. It has got me thinking about the effect of  radiotherapy at a later date for distant mets. Hubby had EBRT in 2020 and, hopefully, will be having SBRT on upper abdominal lymph nodes which are fuelling the rise in PSA. By extrapolation we could be looking at a further 3 years of mopping up the cancer cells? Let's just keep our fingers crossed that the Greek God and the radio oncologist think that hubby is eligible after their discussions - had a text message from GG to keep me informed on what is happening and should be told next week.

Hi David.

I thought of you as our villages are currently inundated with visitors for the TAYGETOS CHALLENGE, which is a range of walking and more challenging running activities through villages, gorges, olive groves and mountain tracks. It is held annually. Maybe something to add into one of your 'Wandeing' expeditions.