Salvage Radiotherapy - with hormone injections or without?

Almondnut

A tough nut to crack if you'll pardon the pun.

On the one hand if the PC has resurfaced after surgery then you probably need to blast it from all sides to try and get rid of once and for all. So yes, HT and then some RT

Of course the other consultant is also right in saying keep the HT for later if needed.

Somehow though it doesn't seem right to keep it for a rainy day, u may not need it later but could do with it now to give the best chance of getting rid of .

The other approach could be to take HT for a limited time which would give some additional time later if needed.

With such a crucial decision to make maybe yet another expert opinion apart from the two that u have already had?

Don't forget new treatments are coming on stream as well

See if others post with their view..

Steve

Hi Almondnut, I experienced recurrence a year after prostatectomy with high risk factors (I had intraductal cancer in my prostate as well as the "normal"tumours). I had a PSA doubling time of less than 2 months as well. See my profile for more information.

BCR (biochemical recurrence) remains very challenging to treat as there are no definitive protocols like there are for primary treatment.

There are some studies which suggest adding hormone therapy improves disease control after salvage radiotherapy.

I had hormone therapy for 3 months before SRT and for two years afterwards. My oncologist decided that this was the best approach due to my short tome to recurrence and the fast doubling time.  He has told me there is around a 40% chance the salvage treatment will have worked. I am currently waiting to see if it has all worked, very nervous just now as a result.

There are lots of articles on what to do after recurrence rears its ugly head. See a couple of references below.

I would ask the oncologist what are the chances of SRT being successful and will HT alongside the SRT be helpful given some studies have shown it is.

If it were me I would be wanting to be on HT for a few months prior to SRT to control the recurrence and weaken the cells for radiotherapy.

Management of Biochemically Recurrent Prostate Cancer After Local Therapy: Evolving Standards of Care and New Directions

Radiation Therapy after Radical Prostatectomy: Implications for Clinicians

Thanks for the replies, much appreciated and we will read the links too.  Helped get clear in my head what we need to weigh up.

The internet is a great resource but can also be overwhelming.