RT got put off until 29th but they seem to be only concerned about pelvic region but I have lymph nodes in spine and shoulder, Don't know if they will look at them as I'm only booked in for 6 fractions.
Hi Fredek, sorry to hear RT has been put back, Do you know if your 6 sessions are just a standard dose of 3 gy, SBRT or 36gy over 6 sessions. I am sure they will look at your spine and shoulder they are trying to contain and hopefully halt any further spread first, take care.
Hi Eddie the numbers and letters don't mean anything to me as I don't get told things like that, I need to ask things but don't know what to ask. I have been able to ask a few questions from what I have learned onthis site.
That's a bummer that your radiotherapy has been postponed. I remember that you were given your diagnosis by an unusual route so don't have some of the information that most people have. You are already on hormone therapy and the medical team would have seen how well you responded to this, along with the results from your scans to decide on your treatment path. In your case it sounds as if they are treating the prostate area first and will then decide to just monitor you with regular PSA tests and to deal with the shoulder and spinal area afterwards if the PSA starts rising. When radiotherapy is given as a first line therapy for advanced prostate cancer there are several options as Eddie has intimated but there has been a lot of work done recently which shows that 6 sessions of a higher dose at weekly intervals is as effective as 20 daily sessions at a lower dose. Who is eligible for the 6 sessions is determined by where the cancer is exactly in the pelvic area. It sounds as if you are one of the eligible men but it is worth confirming this with your medical team if you are unsure. It can take up to 18 months for the PSA to reach its lowest level (nadir) after having radiotherapy so the doctors will be checking that it is going down or remaining stable. If it starts to rise then they will investigate why but I would ask them 1. am I going to have any treatment such as SBRT to the spinal and shoulder lymph nodes in the near future. 2. how am I going to be monitored and who is going to do this.
Your PSA dropped very quickly when you were put onto hormone therapy so you have responded well. This puts all the cancer cells in your body into hibernation, including the ones in your lymph nodes. The radiotherapy should kill the cancer in the area that is targeted. This leaves your lymph node mets so you do need to find out how they are going to be managed, but also, as the lymphatic system can act as a superhighway for the spread of the cancer then you need to ask how they intend to check that this does not happen. Like most men you are a PSA secreter, but because I don't think you know how aggressive you cancer is as you came to your diagnosis by an unusual route, I would make sure that the PSA is tested at 3 monthly intervals so that any possible rise is picked up quickly.
