Adjuvant Radiotherapy. How do they do it...?

Well, I had Salvage Radiation, but I think the only difference is the timing (others hopefully will chime in).

Sorry, but it is not a one-time thing. I had to go for 38 sessions (almost 8 weeks -- the weekends are off).

The treatments last a few minutes and are totally painless, but there is the potential for many side effects. FOR MOST PEOPLE, the first 4 weeks or so are uneventful. After that you may experience mild to significant fatigue and you may have some urinary urgency and maybe some loose stools. But that's the generic answer. It may be totally uneventful. I guess it's like taking a drug that lists 100 bad side effects. Most likely, you'll be fine.

Unfortunately, some SE can occur a year or two after the radiation is completed.

Again, I hope others will chime in.

Mel

Your stats are very similar to mine
I too was only 3+3 at the biopsy but 3+4 after the op.
My PSA before was a bit elss than 10, yours was a bit more than ten
I was 49 at surgery.
And cruciallyt I too was T3b with SVI after surgery.
But the good news is/was that both of us had clear margins.

When they told me about the SVI and T3b they admitted it was not good, but talked in terms of it being not perfect, and that it was still possible that the surgery had removed all the bad stuff.

With good margins ART. ie doing RT straight away without waiting to see if you are still making PSA. is not likely.
What is now important that first post-op PSA score.

If you have a good post-op PSA score, (ie less than 0.1) then that means the chances are very high that while the cancer had indeed spread as far as the semnial vesicles it has not spread further and the surgery will have done the job.
If you have a bad PSA (ie 0.5 or 3) then that menas there is still plenty of bad tissue in you making PSA and you are very liklely to be offer Adjuvant RT to hit it.
If like me you get a PSA of 0.1 that is neither high nor zero then you are likely to be told to do what amounts to post-surgery Activbe Surveillance, which means monitoring that blasted PSA very closely and regualrly to spot any change. If it stays stable then they are not liklely to want to act. If it goes down, then they don;t need to act and if it goes up (as it did with me) then you will probably need Salvage RT.

What they actually do wirth ART and SRT is alomost identical (ART simply gets done straight away becasue something such as positive margins made it obvious that the surgery was not adequate.)

If you have to have RT, then it will be one long batch of about 30 to 35 sessions to deluiver approx 70Gy to the prostate bed. It will be f sessiosn a week for about 7 weeks. So going to Africa would have to be fitted in round that. there is also a good chance it would make you very tired. But there have been guys at HW who have coped okay with long round trips to distant hospitals to get RT and have been able to work all through it as well as immediately after.

But cross bridges when then come.

Alf

glewgle,
As you can see, you have your peers. There are lot's of guys like us but we're just a little harder to find.

I could be your twin except that I was diagnosed at the age of 44. But after surgery found bilateral seminal vesicle invasion, positive margins, and a 4+3=7 Gleason sum, I was a tick further along. Surgery was good enough for a zero PSA after surgery. But that wasn't good enough for me. I am one of the earliest members here at HealingWell to have those results and follow through with adjuvant HT and radiation. As you can see at the five year mark I have excellent disease control and I am very active and healthy. I turn 50 next June.

Just from a friends website I can show you multiple studies. Studies that when I started out were just getting started.

prostatecancerinfolink.net/?s=adjuvant+radiation

That's quite a bit of data that shows that adjuvant radiation and hormonal therapy are working well in our cases.

Keep studying and you can decide for yourself if this the right path for you. But take your time. Radiation has side effects anywhere from very minor to whoops we added one too many. The former is common, and the latter is rare. But you still need to understand them...

Tony

glewgle,

welcome here, hope we can help.

i am the example of how bad radiation can happen. i had salvage radiation, 39 treatments totalling 72 gys. i began to get burned on the 4th treatment (they claim that can't happen). my radiation journey is well documented here. i continued to get burned throughout the entire process. caused terrible pain. at first, doctor kept being in denial, but in the end, had to admit that there was scattering taking place, that, and because of her decision, all my treatments were done with a dry bladder, not a bladder full of water.

i spent the next 51 weeks with a suprapubic catheter in place. too painful to urinate on my own. had hoped that some natural healing would take place, but it never did. was on heavy pain meds the whole time. in the end, i had to have a major surgery to disconnect my bladder (my uro said the inside of my bladder looked like a war zone), and had to have stoma surgery. i have to pee through a hole in my side into a bag for the rest of my life.

the radiation did extensive nerve damage as well, and has left me with chronic pain, so bad, i was made perm. disabled because of it through Social Security Disability. I still am fighting the pain and the heavy fatigue 2 full years after the radiation ended.

and for the kicker, the salvage radiation didn't remotely slow my cancer down, it was considered a failure in less than 9 months, and now i have advanced prostate cancer.

i may be a rare or uncommon example, but things can go horribly wrong with radiation, and often, the full side effects may not take place for 2 or more years after it is administered.

good look as you weigh out your decisions ahead.

david in sc

glewgle,

I had adjuvant radiation. I worked all the way through it. I exercised daily to keep fatigue at bay. SEs were minor annoyances (urgency, frequency, a hemmorhoid that was unhappy). All cleared up within 2 weeks after I finished. I found the routine to mostly be tedious .. up early, start drinking water 30 minutes before my early AM appt ... hope they were on time so my bladder could be full but not ready to explode.