Radiation after surgery

We got my husband's pathology results today and it appears that the cancer was not contained in the prostate as the doctor had expected. We haven't seen the pathology report yet; just a phone call, but he said Harvey went from Gleason 3+3 to 3+4 and is now a T3, and will need radiation. Have any of you gone through radiation after surgery? What should we expect? He just had surgery 3/9 and the doctor said the radiation should probably start in 3 months. Any advice? What questions should we ask?
I thought we were done with the research phase, but is seems like it is just beginning. Thank you. Alice

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Husband age 60, PSA 4.5 ;biopsy 12/09 8/12 positive cores 5% - 50%, Gleason 3+3
DaVinci at UNC on 3/9/10. Gleason 3+4, T3, cancer not contained to prostate

Alice,

Sorry to hear about the possible need for IMRT. A number of us on here have recently completed radiation tx. If your husband does require radiation look for a good radiation oncologist with state of the art equipment, i.e IGRT & IMRT and perhaps Proton. Ask the length and strength of the treatment. Visit the facility to get a feel for it, as bigger is not always better or more comfortable. You can also look for past threads on here regarding radiation tx after surgery and that is helpful. Others on here will give you additional feedback soon as well. Keep us posted and take care.

Michael

Hi Alice,

Sorry you didn't get the pathology report that you were expecting or hoping for. Without giving us more info about the pathology report, it is not possible to make a really meaningful comment. about 3 years ago I had similar stats as your husband (see my signature). I had good post op PSA stats for about 15 month, but then the PSA started to slowly increase. When it reached 0.08 we (Uro, Onc and myself) decided to go to the next level. When radiation stated, my PSA level was 0.1. I had few side effects from the salvage radiation. It is my understanding that radiation has a better chance to succeeding when the PSA level is very low. If the PSA level is relatively high after surgery, adjuvant radiation may be advised by your doctor. If it is quite low, waiting and closely monitoring the level is probably not a bad idea.  

Wishing you and your husband all the best.

Magaboo

I would wait until the first PSA test before I would jump into radiation. Radiation can stop future progress in the continence and the ED department. I would wait for a rising PSA before doing anything. Most Uro docs will try and wait until a patient is continent. Just a thought.

Every situation is different in some way. You did not mention if there had been invasion in the lymph nodes or seminal vissiles.  I too had Prostate Cancer and in 1999 opted for surgery.  My PSA reading at that time was 6.4 and a Gleason of 6 (3+3)  After surgery the Gleason was moved to 7 (3+4) and was diagnosed with T3 with no invasion in lymph nodes or seminal vissiles.  For the first 4 years after surgery my PSA was <0.1.  In 2004 it began to rise slowly and finally in 2007 it had risen to 0.7 and I opted for radiation at City of Hope using tomo therapy.  There were 36 sessions and during this time very little side effects.  In August of 2007 I had my first reading after the radiation and it was <0.1.  Last week I had another reading and it is still at <0.1.  You have time to make the right decision.  Best of luck to you.

 

I also agree wait until you get the path report and first PSA.  My gleason score after surgery was a 4+4 but had undetectable PSA for 9 months.  I recently finished SRT and feel that the time I had to heal before radiation helped me go through it with minial side effects.  Hang in there he needs time to heal.

Jerry1

Alice,
I had DaVinci 10/09 (age 56), path pT3a, 4+5, extra-capsular extensions, positive margins even after taking extra just to be sure. I'll be starting IGRT on 21 April (CT & xrays the week before, markers implanted last week). I was told I needed to wait at least 18 weeks before having the markers implanted to allow everything to heal up. I actually waited 22 weeks, but more because of the Doctor's schedule than mine.
I won't be able to give you much more than the view from a few weeks further down the road, but will be happy to.

Alice,Ialso agree with some of the others I would wait for the pathology report and for the first PSA test as a wife myself of a PC guy I know the anxiousness that you both feel but there is still time to make a decision and it is best to wait until he has time to heal from surgery, this is not a easy journey to travel ,but you and your husband will find a lot of support from these guys here at HW,
DEERHUNTERS WIFE