Husband needs radiation

Hello,

We are new to this, so bare with me. My husband is 58 years old. He was diagnosed in April. PSA at highest was 7.5. Gleason 7 (3+4) before and after surgery. Pathology was clean with the exception of one margin. No involvement in seminal vesicles or capsule. One sided nerve sparing. His first PSA after surgery was .42 and then .26 when it was repeated. We met with the radiologist who recommends 7 week radiation course to prayerfully eliminate what we pray to be some local cells in the bed. I am very concerned about side effects and was hoping some of you could share that have been through this. He is doing well physically and emotionally. Thank you to all who respond.

ssje@88

I have no advice to offer on the radiation treatments, many others here have gone through the experience and I'm sure - as did Southern Comfort - will chime in with what they know.

I do extend the warmest welcome to you, feel free to ask questions. This is a wonderful community of brothers and sisters who support each other.

Bud

Welcome ssje,

It would be interesting to know the date of the surgery and the dates for the PSA tests. It looks like there's a downward trend so perhaps it may drop to undetectable in a little while. If that is the case, even though your husband had a positive margin, he might elect to wait for radiation until there is a confirmed rise in his PSA.

With a Gleason 3 + 4 and no other negative indicators, the risk of recurrence is not all that great, provided the PSA became undetectable after surgery. Some elect to wait for further treatment until it is proven that the cancer has returned to avoid unnecessary radiation and hormone therapy. Studies show that if treatment is begun soon after a rise is detected, it is as effective as if it were done right after surgery.

Here's an article that gives more information: "Nine Decisions Before Electing RADIATION THERAPY After Radical Prostatectomy", www.prostate-cancer.org/pcricms/sites/default/files/PDFs/Is13-2_p8-17.pdf

Of course, if the PSA does not become undetectable, you would want to act quickly, as the sooner done, the better the results.

Best wishes,
Nellie

If you're comfortable going ahead with radiation, it certainly is the only curative option out there, assuming there is something to cure. The PSA test appears to have been done too soon to see if it went undetectable. If it did, there is the possibility the cancer was all removed and the positive margin not viable. Dr. Epstein, the renowned pathologist at Johns Hopkins, has said that 50% of positive margins can't survive because of damage from surgery or lack of blood supply. That's why people often elect to wait to see if they are one of the lucky ones.

It's tough to weigh all the factors with this crazy disease. With Gleason 9 and positive margins, I elected (over my RO's objection) to wait to see if the cancer came back before I went for radiation. Seven months after my surgery, an ultra-sensitive test came back at .01, and then at .03 two months later. Even though that small amount of PSA could come from benign prostate tissue, etc., I elected to go ahead, because Gleason 9 is just to dangerous to take risks. The good thing about waiting was that I had a chance to heal very well. So my radiation was uneventful (just finished by the way).

I hope your husband does well and the cancer disappears.

Nellie

For me it was a non-event. Much depends on your husbands physical condition going in. If he is fit, he should tolerate it well. Some mild fatigue, a little rectal bleeding (not too much), all in all, I've had worse flu's.

Radiation treatments also went every easy for me. Very few side effects. My continence, which was back to almost 100%, did slip some and it may be permenant. Minor periodic dribbling after urination, nothing serious. I did have radiation done at a major cancer treatment facility. I was concerned that my local facility didn't have the latest equipment or the best techs. Best wishes. BB

BB_Fan

I am comfortable, I think.... with the facilities we have here. But we will definitely do the research. He has his appointment to be "mapped" I guess they call it, next Friday. He will start treatment after he returns from his Moose hunt... priorities!

STW,

Thanks for your input. I hope my husbands goes as well as yours did. I too am concerned about the closeness of it to his surgery....but he feels this is the correct decision for him to make right now.

You have all been so helpful!