Post radiotherapy - radio silence

Hi Paulo and welcome 

You don't give any other figures which would be handy IE staging TNM no's etc, presume contained in the gland with a very low PSA 

MRI not normally done after Radiotherapy as the gland turns into a kind of mush, probably not much to make out.

But in your case it's a bit different as PSA  abnormaly   low for someone with PC.

I would Def push for a scan at some stage, probably leave a few months and then ask again

Good luck

Steve 

Hello Paulo100 .

This is a conundrum that is often debated as the medical professionals take a clinical view but forget about the psychological benefits of knowing whether the radiotherapy has worked. The Royal Marsden has an excellent record in dealing with cancer - my husband's medical oncologist was trained there even though he has now returned to Greece to practice. NICE have set down guidelines on monitoring different types of cancer and treatments but it is up to the discretion of the medical expert whether a variation is needed based on your particular type of prostate cancer. An initial low PSA can be a warning sign but it depends on whether the histology showed any particularly aggressive features which might warrant closer monitoring such as neuro endocrine. Unfortunately prostate cancer is the only cancer where there are no routine scans following treatment in the UK. How long you have been told you are on HT will give you an idea of whether there is concern about aggressive features - the shorter the less aggressive. A Gleason 7 cancer will not normally grow that fast and PSA monitoring is OK for the majority. With the low initial PSA I would say to your team that this is causing you concern and see if you can push for a scan after a few months. My husband does have regular scans every 3 months as his cancer is advanced and from his records it was reassuring to see the tumour in the prostate shrinking over time. He has recently had SBRT to distant mets and the radio oncologist has asked for scans two months after completing the course so the inference is that they expect to be able to see some difference in that time.

Alwayshope

Thank you for your reply. 

I did push for an MRI but was told that it wouldn't show anything at this early stage. I have been placed on early more frequent PSA checks (4 monthly instead of 6).

As I mentioned in my first post, I have little faith in the PSA test now having been on a self-imposed annual test regime for many years, all of them coming in at around 1.0 only to find that I had a tumour following a self-funded MRI scan.

Thank god I did the MRI even though my partner thought I was being unnecessarily extravagant with such consistently low PSA results. 

Apparently, a tumour combined with low PSA results can indicate an aggressive cancer.

Incidentally, I was not put on HT treatment as my prostate was not enlarged, nor am I having it now. 

It seems to be a case of wait-and-see in terms of whether my cancer is gone or not. It would be nice to know one way or another. 

Thanks again for responding. 

Steve 

Yes, I was told there would be nothing to see with an MRI after the RT treatment.  I imagine my prostate is not unlike a bombed-out building the morning after, a mass of rubble with some smoke curling lazily into the sky. My wife winces when I use that analogy but I quite like the thought of that alien tumour in my body being destroyed by the Royal Marsden death beam.

I am going to push for that scan, MRI or whatever scan is best, at a later stage. 

Yes, I like the analogy but can understand the WW, (wincing wife)
As u have said hold fire for now and push forward again when settled down.

Best wishes

Steve