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Radiation after failed surgery and radiation?

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Posted 9/14/2015 12:59 AM (GMT 0)
Who has had more radiation to lymph nodes after failed RP and radiation to Prostate bed after increasing PSA ?
Bob
Posted 9/14/2015 2:02 AM (GMT 0)
Sorry, not me.. but I am interested in the question due to relevance to my case. I'll be watching the thread.
Jeff
Posted 9/14/2015 2:03 AM (GMT 0)
Bob: Of course you know I have. It sounds like you saw Bravo and Dattoli, if you did what type of scan are they now doing at Sand Lake?

David
Posted 9/14/2015 11:40 PM (GMT 0)
David
They did f18 ct pet and 3T MRI with contrast. They are not using feraheme any more. I have not received the results, but Im being told by the nurse (Ann) at Dattoli that I should plan on seven weeks of RT. My PSA has risen to 1.22 from .7 so it's on the way up quickly.
I don't like the secrecy around the reason for more RT. To date I've had no Mets but perhaps mets were discovered this time (9/9/15). I need to know why more RT is recommended. I have started ADT again this time with more ammunition ( casodex , lupron, Avodart) per Dattoli rec.
Is Dattoli one of the few who use RT after failed SRT? Is it accepted by any other Radiation oncologists ? I don't care if it is just wondering if it's considered appropriate.
Bob
Posted 9/15/2015 1:47 AM (GMT 0)
Bob,

I've had radiation to 2 bone mets (a few years ago). That was after surgery and adj radiation.

Given my slowly increasing psa and results of recent fancy scans, I might be doing the same fairly soon....tbd

My local radiation oncologist is on board if we go down that road.

Jerry
Posted 9/15/2015 4:02 AM (GMT 0)
Bob, my RP failed after 6 months and when I went in for my initial RT consult, my RO said he would do the lymph nodes and the prostate bed area at the same time. He said there was no reason not to do them at the same time, so I took his advise.
Posted 9/15/2015 1:21 PM (GMT 0)
Bob: Thanx for the info. It's a little surprising that Dattoli hasn't taken the time to explain to you where he believes the cancer still is, he was very open with me about it. I had full pelvic radiation before I saw him( which actually is just to the nodes around where the prostate was, for the life of me I don't know why they call it full pelvic) as my SRT. I had a couple of nodes that were extremely swollen that were picked up on the feraheme scan, Dattoli was very unhappy with Bravo because he didn't biopsy them for 100% confirmation but I trusted Dattoli based on his experience to be correct.

I do believe he is one of the few Rad Onc's who will do more radiation even after SRT. I did it because my doubling time was so quick, I knew I was facing ADT for the rest of my life and probable failure pretty quickly so I thought I needed to take a shot at it. There were numerous guys at Dattoli's doing the same thing I was doing. They were from all over the world which told me not many Doc's go down this road. It was a tough call but so far so good. (2 years later.)

Good luck and keep in touch if you can.
David
Posted 9/15/2015 2:32 PM (GMT 0)
Don't take my experience as medical advice, because your docs may know something mine don't. After almost 5 years of undetectable PSA (0.00) I began having detectable and rising PSA since last October. When I had my SRT part of each day's dose was targeted at an enlarged lymph node. My current PSA is not yet at a level that I would want to do anything about it, but I have discussed next steps with both my RO and my uro. Both say next step for me would be ADT. RO says any more radiation in the vicinity of my SRT would risk damage to other organs. I'll want to consult a medical oncologist, if continued rise calls for it, before I decide on course of any further treatment.
Posted 9/15/2015 7:10 PM (GMT 0)
After reading what I posted above I believe it may appear that I had more radiation to an area where I had already had radiation at. That is not the deal, my target field with Dattoli was in a different area from where my SRT was done. I just don't want anybody thinking that they could have an area re radiated. I don't believe any Doc would recommend that.

Thanks
David
Posted 9/15/2015 8:51 PM (GMT 0)
David
Like you I'm still trying for the illusive cure albeit Dr Myers likes the term long term remission for high risk guys like us. I stupidly did not have IMRT to the nodes when I had SRT so now that's what I'm facing. The fact that Dattoli was used by Myers and Myers refers patients to him is good enough for me. So I'm off to the radiation merry go round starting next week. A two month vacation in Sarasota! At least I'm not heading to cold weather.
Bob
Posted 9/15/2015 8:58 PM (GMT 0)
Bob: Good luck and be sure to eat at one of the Amish restraunts, they have a large area in Sarasota and they have great food.

David
Posted 9/16/2015 1:06 PM (GMT 0)
"Who has had more radiation to lymph nodes after failed RP and radiation to Prostate bed after increasing PSA ? " My hand is up. See profile for details, briefly nano-iron MRI at Nijmegen June 2014 found eight infected lymph nodes, para-aorta and common iliac, did 55 gys of IMRT, 50 to the general area and 5 to the specific nodes, along with 4 months of Firmagon, treatment was first half of this year, latest readings testosterone 26, DHT (I also take Avodart) 1.5, PSA undetectable.
Cigafred
Posted 9/16/2015 1:15 PM (GMT 0)
I have been dealing with this issue. Had surgery, later SRT. PSA kept rising . Got on HT (Lupron plus Casodex).
Got to take a HT vacation when I went to undetectable. PSA then started rising dramatically. Did C11 Choline scan at Mayo. Found one very small hot lymph node (pelvic). Was going to do follow-up radiation. But the RO gave me a 10% chance at best (of getting good results). Given the GO SE profile, I figures there was maybe a 8%-9% for success with no major SE.

I decided at that time not to do it.

I am back on HT. Getting PSA done in a few days. If it stays down, I may be heading for a second HT vacation. When PSA starts to rise again, I will probably re-do the scans. I may get another chance at the radiation and will think it over again. I may also look into SBRT.

Mel
Posted 9/16/2015 10:08 PM (GMT 0)
Sounds like a lot of us are in this leaky boat. My consult with Dr Dattoli is 9:30 Wednesday when I'll find out the next steps.
Bob
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