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Are all prostate cancer patients "fit" for salvage radiotherapy?

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Posted 1/31/2020 2:20 PM (GMT 0)
Are all prostate cancer patients "fit" for salvage radiotherapy? [2020, Full Text]

This paper emphasizes some good points, e.g. " It is important to keep in mind that administering SRT in patients with PSA levels > 1 ng/mL without first localizing the lesion via imaging tests increases the risk that the affected area (particularly lymph node regions) will not be adequately irradiated."

Djin
Posted 1/31/2020 5:20 PM (GMT 0)
Disclosure, i clicked on the link, but only read the abstract.

This goes to the heart of all the discussion we have here about early salvage. In a sense, we are rolling the dice, playing the odds. We dont know definitively where the PSA is coming from, and so we take the (high) odds bet that its in the prostate bed. In my case, i was told 80% chance. Without imaging locating the source, its all about how lucky one feels, in deciding to treat or wait.
Posted 1/31/2020 5:42 PM (GMT 0)
I echo what Pratoman wrote. I went for SRT after my post-surgery PSA hit .34 and scans showed no cancer. I rolled the dice with radiating my whole pelvis. 6-year progression-free is estimated at 67%. I’ll take those odds despite any potential side effects.
Posted 1/31/2020 5:55 PM (GMT 0)
one reason dual or triple play works so well even in high risk cases is cancer is local and treatment is initiated "early".
Posted 1/31/2020 6:02 PM (GMT 0)
I did the same as MotownPaul and had whole pelvic SRT when my PSA rose to .441 a little over 6 years after RP, and a negative Axumin scan.
Posted 1/31/2020 6:08 PM (GMT 0)
The 1st half of the second sentence. Didn’t much care for the tone....
Posted 1/31/2020 7:08 PM (GMT 0)
Men who are high risk after RP men or who follow forums and do their own research are attuned to the early/very early SRT issues. But there are many men who do not take advantage of SRT. You find papers that call SRT at 0.1 or 0.2 a"early."

Djin

Post Edited (DjinTonic) : 1/31/2020 8:40:56 PM (GMT-7)

Posted 1/31/2020 7:40 PM (GMT 0)
As per my signature, received an 18F-DCFPyL Pet scan 6/18 which identified 2 LN+ for small lesions in the local prostate bed area.Received RT to local prostate bed and image guided RT to LN,s 11/18. PSA was 1.17 at the time of the scan. PSA is .04 as of 11/19. Next draw 2/20. Meeting with the RO, 2/25/20.
I am glad that I had the more sensitive scan to identify the positive LN's and that they could be targeted. We will see if the RT worked.

Dave
Posted 1/31/2020 8:02 PM (GMT 0)
Right, Djin. In my case I had a world renowned Uro who kept telling me not to worry until I decided to take matters into my own hands after the Axumin scan. I did have a couple ultrasensitive increases this year but now stable and still undetectable today according to my MO. Following up with my RO next month. I remain hopeful.
Posted 2/1/2020 1:52 AM (GMT 0)
Truth is Italatin...you will never know if your renown uro was correct...but you are happy with result...so good for you...PsssT,,,shhh...you may have had the same result if you never pulled the trigger....sorry to pick on you...most do what you do and are happy with the relief rad oncs know this hence.. renowned uros have no skin in the game...he may have been and may not...as Prato said 'roll the dice'...again this factor also skews everything when it comes to studies and stats on srt/art success...lil things folks don't know about Pca treatment studies and da rest... if you like to play the odds...my advice is to stick with medical system...over forums such as these...one exception to this advice is most forums now a lot more than local urologist specially the ones who have been your long time family uro,,,they are the worst...because of trust....you can get sucked (not intentionally by granpa's uro and suffer . nasty s/e
Posted 2/1/2020 2:47 AM (GMT 0)
Truth is logo, after my PSA kept rising I don't believe he was right, world renowned or not. Thanks to consultations with two MOs and two ROs at other cancer centers of excellence, and the advice of a certain well known former member of this forum who has moved on, I made a choice and also moved on. And I'm glad I did. And not to worry, I do not feel picked on. I'm not so sensitive. I have been hanging around PCA forums for nine years now and I recognize there will always be those that have their own opinions, some that believe they know more than everyone else and some that believe they have all the answers. I applaud you for the choices you have made.

Have a good weekend.

Post Edited (Italatin8) : 1/31/2020 7:59:17 PM (GMT-7)

Posted 2/1/2020 2:53 AM (GMT 0)
What I said is a fact...regardless of my using you to point it out to others who may be tempted to start...needlessly...arguably... early srt…..it does skew studies and stats...this solid truth is obvious to the learned...did you ever think to raise this possibility to you medicos and honestly did you ever think about the truth of what I stated in your learned dillegence…your response was classic strawman logic...but you must know this with all your experience....another young gun...I may change my display name to Jonny Ringo...I think a touched a nerve...ouch... now if you tou point out any of my spelling mistakes...well Im sure yo post on yahoo political arbuments as well as forums...so you will bw tempted to...oh heck a lol is definitely needed here...check...next
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