Starting IMRT treatment Monday for failed Robotic Surgery

Sorry to hear your surgery failed...The 40 or so radiation treatments get kind of boring....How far do you have to drive to get your treatments? My appointment was 9am every weekday..That worked pretty good for me..You want to avoid rush hour..In the morning, the technicians who will be administering your dose are fresh and delays are less likely..The machines that administer the radiation are called LINACS and for the kind of money being spent on this, I would insist on late-model equipment..Something like a Varian Rapid-Arc..The newest machines are more accurate in hitting the target, have more advanced safety features and are quicker in administering the dose with less exposure to healthy tissue..

Best of luck to you...

Sorry your surgery failed. I've seen nothing but optimistic and positive reports here from the folks who also went down your road.

I read these threads with great interest because I feel I may also travel down this road at some point.

Thanks all for your responses. Finished day 2 of IMRT, no issues so far. I have a question - My radiation oncologist did not recommend Hormone therapy with SRT  -- he did say it was my decision and if I wanted it I could do it.  With my rapid rise in PSA after Radical prostatectomy (0.34 5 weeks, 0.52 12 weeks), I am not sure if SRT alone is the best step for me or i should also include hormone therapy asap.    60 yo here is my info. ====================================================== Diagnosis: A.       Radical prostatectomy specimen (46 g) -           Extensively involved bilaterally with prostatic adenocarcinoma (Gleason pattern 4+3, total score 7) -           Approximately 45% of prostate slides contain tumor -           The greatest diameter of tumor is 1.8cm in the left posterior inferior aspect of the gland -           The tumor extends into, but not beyond the prostatic pseudocapsule but is focally present at a right posterior mid pseudocapsular recestion margin -           Intraprostatic perineural infiltration with tumor and high grade PIN are identified -           The apical, base, pseudocapsular and soft resection margins and seminal are negative for tumor B.       One Lymph node negative for tumor C.       One Lymph node negative for tumor AJCC stage: PT2NOMAX   Prostate Gland:                 Histologic Type:                                 Adenocarcinoma (conventional, not otherwise specified)                 Histologic Grade                Primary {Pattern Grade:   4                                                                 Secondary Pattern Grade;   3                                                                 Total Gleason score:   7                 Primary Tumor(pt):          PT2: Organ confined                                                                   Portion of lobe involved   PT2c: Bilateral disease                 Regional Lymph Nodes:                  pNO: No regional lymph node metastasis                 Number of nodes examined.      2                 Number of nodes involved:         0                 Distant Metastasis(pM):                pMX: Distant metastasis cannot be assessed                 Seminal Vesicle invasion:               Seminal Vesicle Invasion absent   =====================================================   I have checked out the Memorial Sloan Kettering calculator and it shows a little better result for SRT with hormone therapy.    I also understand that just doing the IMRT i will have better understanding on if it works based on psa going down and i can save the Hormone therapy for later if or when needed.   Just wondering what others my think.   thanks

Burgess, I am also in Hartford and have gone down the SRT road, two years ago now. I had failed surgery (Hartford Hospital), but my PSA did go undetectable for all of 9 months. Two years ago the folks at Hartford Hospital were very much against ADT with SRT. They would agree to a 3 month shot of Lupron only. I really wanted to try the combined therapy of SRT with ADT and swtiched to Dana Farber for treatment. Although dragging my butt to Boston and back every day for 8 weeks was no treat. I was on ADT3 for 12 months. Radiation was a walk in the park for me, no SE's from treatment, but it did worsen ED. Best of luck with your remaining treatments.

Send me an e-mail if you would like to discuss further. BB

Warm socks. I recommend warm socks. That really helped me get through all the treatments.

Hello and welcome, Burgess.

Like some others here, I had a failed surgery, then underwent salvage radiation 9 months later. Had 39 sessions totaling 72 gys. It was the 2nd time in my life that I underwent major radiation, it's best looked at as being an endurance contest.

Unfortunately, my radiation also failed to stop the cancer within a few months, and it was administered incorrectly, doing major damage to my body, but that is another story.

As far as HT and radiation, two schools of thoughts, that even the best Radiation Oncologist don't agree upon. When I was interviewing RO's. I spoke to 3 different ones. Two said firmly, do the radiation alone to see if it works, then if you need HT later, fine. The third one started to talk about the advantage of HT with the radiation, but when I pushed him for proof, he backed away. In the end, he said he couldn't prove that it would help, and he couldn't prove that I needed it. So I took that as a "no" answer.

Hope you get through the rest of it without too many side effects of discomfort, and more importantly, hope it works for you.

Please keep us posted, and good luck.

david in sc

Burgess,

My uro did not want me to combine HT & RT, under the idea that the HT masks the effect of the RT. He likes to do one thing at a time. My medical oncologist agrees with that approach.

The RO wanted HT, but faced with two much more respected docs, did not insist.

I think they did the right thing, since my PSA started shooting up after RT. This way we knew the PCa was already well outside the prostate bed. At this point, based on bone scans, we are looking at likely hip and spine mets that have been there for a very long time.

But as everyone says, each case is a case. All are unique.

Keep a daily note of what is happening. It will help the doc if you have any issues, and will help you down the road as you want to build a time line.