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Just curious, has anyone had a failed radiotherapy and went back again for RT?

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Posted 12/15/2021 10:48 PM (GMT 0)
Just wondering, my oncology urologist mentioned that if my IMRT/IGRT failed, he can treat the re-occurrence with focal treatment? I would assume he is talking about radiation again, but then I could be wrong. Are there other focal treatments other than radiation?
Posted 12/16/2021 1:38 AM (GMT 0)
I posted a thought, but didn't realize that lapilot is without a prostate...
Hence, I deleted the post.
Posted 12/16/2021 2:50 AM (GMT 0)
Several focal treatments are available including cryo, HDR brachytherapy, HIFU and NanoKnife. These can be tailored to treat small targeted areas which would be focal. Some are radiation, some are not. With radiation, the prior radiation has to be taken into account to limit toxicity.
Posted 12/16/2021 10:05 PM (GMT 0)
I posted a thought about senior sailors thought and at the exact instant I melted...it was like Buttah..oh and plz do not post what I think you will and break my curse
Posted 12/17/2021 12:44 AM (GMT 0)
If you had whole pelvic vs prostate bed more RT is unlikely.
Posted 12/17/2021 2:42 AM (GMT 0)
I failed surgery and then failed SRT (guess I was a poor student). The SRT was to the prostate bed. Subsequent scans found 1 or 2 hot nodes (ext. illiac nodes) and I had focal SBRT. This happened twice.

Mel
Posted 12/17/2021 11:43 AM (GMT 0)
A friend of mine had a brachy insert to a hot node. Not sure if it was brachy boost but it is certainly focal and might be what the onc is referring to.
Posted 12/17/2021 7:42 PM (GMT 0)
Mel, What type of scan did you get that found the ext. illiac nodes?
Posted 12/17/2021 11:03 PM (GMT 0)
Mel,

How long ago were the first and second treatments after the original treatments? Did you have any side effects from the additional treatments?

Thanks!
Posted 12/18/2021 12:02 AM (GMT 0)
ED and LA: Here are some details. Hope this helps

DX 12/09
RP: 1/10 (did lots of research before dx)
SRT: 3/11
Then assorted HT and HT vacations
Eventually:
11/14--C11 choline scan. Found 1 hot node
Did SBRT with Chris King at UCLA shortly thereafter

PSA suddenly started rising: 2.3 to 6.9 in 1 month then 7.8 two weeks later so:

Approx 12/18-- did ga68 PSMA scan after rising PSA. Found 2 hot nodes
01/18-02/19--did SBRT at Umich. They did 10 days worth, zapping nearby nodes too.
Doing well since then. PSAs from 0.21 to 0.75 currently 0.41. Up and down. If pattern develops will do a PSMA scan again.

My SEs from last scan: nasty D, starting around the 7th day. Doc said it would last about 7-10 days after SBRT. It did last about 8 days.

Mel

Post Edited (compiler) : 12/17/2021 5:05:23 PM (GMT-7)

Posted 12/18/2021 10:43 PM (GMT 0)
Guys, thanks for the information. I wasn't sure if radiation can be given again if PSA becomes detectable.

FWIW, I believe I originally had just prostate area radiated because I did have a 1mm positive margin.
Just have to see if the last Quest post-prostate PSA was just noise and hopefully the less than sign comes back.
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