This involves radiotherapy to the prostate bed usually with hormone treatment before, during and after. Read my blog 'Salvage radiotherapy - another journey', which gives my prostate op history and an account of the radiotherapy over 33 sessions, finished at the end of May. This will give you some idea of what to expect. Any more questions, happy to help, if I can. Regards, Phil
Hello sadly I am going to have this now as my PSA went to 0.2 after initial 0.09 so we are now going to do salvage of 70 Gray over 35 sessions with IMRT and IGRT .(seven months after RP for Gleason 9)
I have declined hormone treatment as a very intelligent Austrian professor has asked me not to as he says it can cause multiple other problems.
I have little idea of what to expect regarding side effects ,as was quite happy that my continence had become relatively good (was operated on February 14 th)
All my urologists now say must do RT and thats 4 ,but two say ADT also.
My research seems to indicate that ADT offers marginally better chances of limiting recurrence but does not necessarily prolong life.
In Munsons book about surviving Prostate cancer after a Biochemical recurrence he also points out that ADT does not cure cancer but delays it .
Ultimately if all else fails there is a new Lutetium therapy with Gallium 68 .
I am doing this therapy in a private hospital in Spain and they have told me that I need no special diet or preparation before my first session on 28 September.
They say they have IMRT and IGRT and will do 70 Gray over 7 weeks
These days they seem to like giving ADT together with radiotherapy, increases successful outcome so they say.
My view, for what it's worth, go with the RT for now, keep the ADT for the future in case u need some more treatment, hopefully not. don't forget this is just my opinion and others might not agree.
You are correct, PC can't be cured with ADT but can be with RT even after a failed surgery.
Just to let u know, I had RT without the ADT, the specialist could see my reluctance. I didn't have the surgery though.
All the best
Steve
Ps . for future reference it is better to start a new thread than using an old one, Uncle Phil posted 6 years ago
You won’t be able to have gold markers for salvage radiotherapy as you don’t have a prostate. The planning scan will be very detailed to help target the radiotherapy. When I had salvage radiotherapy in 2017 they did a scan before each session to make sure positioning was accurate. I could feel the table moving very slightly as they adjusted my position to be the same as the planning scan. I also had ADT which started 3 months before radiotherapy and continued for 2 years.
Did he say what the "multiple other problems" were?
If they are 'short term' you might consider they're worth it, if the hormones increase your chances of a longer life (even slightly). You can see the logic: shrinking the tumour enables the Radiotherapy to be more tightly focussed.
If you are going to decline a treatment generally seen as useful, you need to consider your reasons for declining.
It's kind of a risk assessment - and you can't choose the least risky without being clear on what the alternatives are.
On diet: you will need to consider bladder and bowels: if either is full, then the tumour may well be in a slightly different place than if empty (same rules apply for radiotherapy as first-line treatment. If your bowels are fairly regular, that shouldn't be a problem, and the radiographers will advise on fluids - same go for an empty bladder, some a full bladder. Consistency is what they want.
Good Luck, whatever you decide.
- - -
Heinous
If I can't beat this, I'm going for the draw.
Meanwhile, my priority is to live while I have the option.
there were no visible lesions but at 0,20 psa was not expecting it ,had pet cholina in January was also negative.except for the tumour itself
Am hoping we are restricted to prostate bed as my lymph nodes were clean in the final histology.
The surgeon had to avoid cutting the bladder as the frozen biopsy showed cancer close to the edge.
The final histology however showed 2 mm margin and R0 but I was classified T3a ,but as final histology was R0 one wonders.
There is a chance there is benign prostate tissue which is inflamed.
Some inflammation showed in the suture area on the PET PSMA and as I had tissue with prostatitis it is not clear.
Now this is impossible to really know,one urologist wanted to actually wait but the thing is if you wait till 0.5 then you have little chance of cure with Gleason 9
I am 69 but relatively ok and have joint pains but no real bad stuff and look outside pretty good..
I hope that the RT does not destroy my good continence.
I am surprised the Spanish have told me :Eat and drink normal on Monday.
That would not be good as a bottle of wine might have a bad effect....
I must say I am surprised about this ,in the old days they wanted you to be empty except bladder.
They have put 4 microdots in me that I can no longer see.
They claim they are good,as I do not want metastasis I think this might improve the odds. The Austrian Professor told me that we could try the Gallium 68 therapy but most only recommend it if all else fails.
Even he say that the recommended therapy here is prostate bed RT.
But he pleaded with me not to do hormone therapy.
I agree
Nice to hear from you,and any thoughts on side effects are appreciated.
