1st PSA test after SRT

Looks great One

Can't get much lower.

although my PSa has been going down very slowly since my 2017 treatment it's not as low as that.

I presume you are not on HT as well.

Long may it continue .

Best wishes

Steve 

Definitely a good result to have an early reduction of PSA to 0.1 with the target to reach this level within 6 months of salvage radiotherapy. For anyone interested in the subject then I have attached a link. This article suggests having salvage radiotherapy gives best results when the PSA following prostatectomy is below 0.2. Another article suggests that the risk of a future recurrence after salvage radiotherapy may be associated with perineural invasion and is associated with seminal vesicle involvement amongst other things.

https://www.tandfonline.com/doi/full/10.1080/0284186X.2017.1364869

https://bmcurol.biomedcentral.com/articles/10.1186/s12894-023-01323-5

Good Evening Onestepforward 

That's great news, long may your PSA continue to drop. I love posts and threads with good news.

Best wishes - Brian.

Thanks Grundo

Yes I haven't had any HT and hoping to avoid same. 

Going down and staying down is the hope, ideally to undetectable levels. 

Good luck!

Thanks Always hope. 

I agree and the articles you have attached are great. My Onco was wanting to wait until PSA reached 0.4 before treatment but I pushed and requested it as soon as I got a 0.22 reading.

Another articles I read said getting SRT at 0.25 or less provides better outcomes.

Another thing that seems to vary is the amount of radiation given. I was given 52.5gy over 20 fractions which equated to around 2.66gy per session. I have read where others have been given 66 to 70gy with up to 33 or 37 fractions. Does anyone know why the different approach??

Thanks for your thoughts and good luck

I am surmising here. My husband had 33 sessions 4 years ago which was split into targeting the whole of the pelvic area at a lower dose with a boost to the areas where the MRI had identified the cancer. This was done on one type of machine. This year he had a targeted high dose radiotherapy of 5 x 6 Gy to a different part of the body on a different machine as greater accuracy was needed. Trials have shown that the 20 sessions of a higher individual dose, but lower total dose, is just as effective as the 33-37/38 lower individual dose, higher total dose regime. Most recently it has been shown that for some men a 6 x 6 Gy on alternate days has equivalent results. There are different types of machines which have different capabilities for accuracy. Some give a fixed beam whereas others move around the target and can take in to account the movement of the organs as they move during breathing. All of this work has been done on men with an in tact prostate. In your case the prostate has been removed so there is a smaller area to be targeted with no boost and, therefore, I presume less total radiation is required. This is where the expertise of the physicist comes in to tailor the dose and margins according to the individual. There are limits to the amount of total irradiation you can have in a specific area so finding that the 20 and 6 sessions work as well as the 33 - 38 sessions means that there is a greater possibility of future targeted spot radiotherapy if needed for these men.

I had 20 sessions of IMRT with gold markers,  60gy, 

I think it can vary and there are different kinds of RT not all using the gold markers.

Probably ask your cancer centre why the difference 

Regards 

Steve