SRT being recommended, thoughts?

After my PSA two months ago of 0.15, I had another one yesterday which came back at 0.24. Definitely rising and based on prior PSAs it's accelerating. PSADT is probably less than six months, but this is still pretty low level.

Given my past statistics and my age (soon 54), my Uro is recommending consideration of SRT. Should mention that in the past two months had a negative PET/CT scan. I'm three plus years out from surgery with good continence and pretty good erectile function.

Off to a consult with RO on March 16th. Really don't like the concept of radiation. Interested in your thoughts. Thank you..

First thought - just listen to TA.

Second - there are worse things than a little radiation. Yeah, it's not what you want but it's likely to do the trick and the SEs aren't that bad.

and, don't expect to grow a third arm or get x-ray vision. I keep hoping but it doesn't happen...

Adnrew

Hi
Yah..after surgery, if BCR ...it is decision time again....any treatment chosen...they are potential SE.
Need to evaluate the risk & the gain.
I have chosen SRT as I have also heard about HT treatment.
So far after a week of treatment, I m glad that the radiation team are very careful on the preparation before I go under the 'beam'
All the best to you on whatever treatment you choose.

I am one of those cases in which SRT appears to have worked. But I have to admit I was very skeptical about the chance for success and the horror of stories of those who had botched SRT (Purg above for example) nearly caused me to hold off any further treatment. But I was convinced by my RO that the cancer was where he said it was and that the treatment would be effective. So far he was right and so far the side effects and complications of SRT have been minimal. In a way I am batting 500 on my choices for treating PC. Surgery failed for me but I still feel I made the right choice for me at that particular time. You have to decide for yourself and hopefully hearing from both sides will assist you in making the decision that is bet for you. Good luck with whatever you choose.

Thank you all for taking the time to provide your insights. I'm preparing my question list for next Monday's consult with the RO. Also I thought I would give the MSKCC nomograms a try. PSADT is 7 months and the 6 year progression free probability after SRT is 53%, so essentially a 50/50 proposition. Pretty much aligned with Purgatory's assessment. Not sure how much faith to put into these statistics. According to the Post-Radical Prostatectomy nomograms, I only had a 5% chance of having recurrence in 5 years and here I am in that group.

Based on what I read and was told before my SRT, I went into it with an expectation of no better than 30 percent chance of cure. Now, nearly 5 years after my SRT I have indications that my uro and RO agree show that the PCa is probably returning. But even if I end up needing further treatment sometime in the future, I believe the SRT was successful in giving me quite a few additional years before I will need to agree to ADT and its side-effects. Also had I needed to pull the trigger on ADT earlier, it would have started the clock running on those treatments' effective usefulness years ago rather than at some point still in the future.

If you go ahead with SRT do it with your eyes open and mindful of the fact that the treatment is not risk-free -- your will be receiving a lot of radiation that has the potential to do damage if not precisely targeted and your chance of cure is probably less than even. But there is also the possible benefit of some added years of more or less normal quality of life, even if you need to move on to more aggressive treatment down the road.
Jim

Behemond and Tudpock - Thank you for your valuable insight. Seems like I'm facing a not so clear cut decision on SRT. Looks like a less then 50% success probability with a risk of SE radiation damage. Not sure what the probability is for the SEs. I'm going to have to give it some serious thought and go with a decision and not look back. I guess I did that once almost four years ago and have to do it again. I feel I had better odds when I was in Las Vegas last week, but probably not.

BD

My side effects were minimal, as I believe are most people's. However it is possible, though rare, for things to go badly wrong -- case in point being Purgatory who commented above. My SEs were some urinary urgency that began about halfway through the treatments and then receded to near-normal a month or so after the last treatment. I still have occasional urgency but at this point I can' say for sure if it is more or less than I had post-surgery and before SRT. Also about 8 months after SRT I started having some rectal bleeding which continued intermittently (several times per week) over a year or so but gradually ended. I had none of the fatigue that many report having. So all in all, the treatment wasn't bad and it has bought me at least five additional years without having to consider ADT.

Jim