Radiotherapy with bilateral hip prosthesis

Hello AskingForFIL 

Welcome to the group. There are a few recent threads on recurrence following prostatectomy so have a delivery in to them. I have no experience of pelvic radiotherapy and metal hip implants but I have done a little trawl of the literature which seems to imply that it is a possibility provided the correct machine is used. Under the circumstances I would get a second opinion as having radiotherapy can offer the potential for a cure whereas HT can put the cancer into hibernation.

https://ro-journal.biomedcentral.com/articles/10.1186/s13014-021-01975-3

Hi AskingForFIL , you mentioned that he had a PSMA PET rather than CT, which is good.  At present nothing is found outside the prostate area.  RT would be a natural choice at this point, but having 2 metal hips makes it almost impossible to do.  I am not medical, but the problem with metal in the area would very likely cause defraction and deflection (and possibly reflection). none of which are great when trying to reduce damage to other areas.  Given his situation, from what I know, I would opt for immediate HT to stop any spread for a few years and take your time looking at options.  I have been on HT for years and haven’t had too many issues.  Good luck, David

Hi Alwayshope , I hadn’t seen your reply until after I had replied to AskingForFIL .

Just a word of caution, I think the article refers to initial prostate RT,  whereas in this case the RT treatment would be looking for a wider pelvic spread, so would be more tricky.  Definitely worth seeking a second opinion but I stand by my initial thought about starting HT asap.  David

Hello AskingForFIL 

Another warm welcome to the online Community from me.

PSMA -PET scans are very accurate (you would expect so at £2600 per go). I am assuming if it's not found anything your father in law's PSA count is very low. For me, and this is my personal opinion, I would do nothing until the next PSA test. If it's another rise ask for another scan.

If you could let us know your father in law's age and his PSA readings this would help. I am one for not treating it if it's very low and not rising, also depending on his age if his readings are low why put him through HT? Of course these are my thoughts not always the correct course of action.

Best wishes - Brian.

Thank you David. This is a more detailed evaluation.

https://www.sciencedirect.com/science/article/pii/S0939388921000581#:~:text=Metallic%20hip%20implants%20(MHI)%20are,complexity%20of%20the%20treatment%20plan.

Thank you all so much for your incredibly helpful replies. My Father in Law is awaiting a call back to go and see his consultant to discuss the reasoning behind why he’s unable to have the radiotherapy. After lots of calling round to various places yesterday it seems it’s doable but complicated. 
I’ll update here when we know more in case it helps anyone else in the same position. 
Thank you all again.