I am at a loss. My tendency is to analyze till I paralyze. Throughout my journey I have gathered a great deal of information from the experience on this forum. Now I have reached a critical point in my treatment. I have conferred with at least two members of the forum outside of the threads, now I need to once again call on the collective experience of the forum members.
The issue is HT along with RT. In December of 2010, after RP in September, 2010, the surgeon at the Cleveland Clinic advised me to have RT within a month. I have been dragging my feet trying to decide where to go. I know I need RT with seminal invasion. The radiation oncologist in Erie has recommended two years of HT along with radiation. He is at the Regional Cancer Center, and the director of this center which is affiliated with University Pittsburgh Medical Center (little bit competition between them and Clinic).
What also amazed me is that my PSA still remains at < .03. That is at about
4 ½ months out.
I have heard some nasty side effects from HT. I am 66 ½ - is it worth it?
I also read this regarding RT.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2692148/#__secid3736737
Summary of study.
The benefits of early radiotherapy in other paradigms have been established. There is level I evidence that ART has acceptable, well-tolerated transient toxicity, which dissipates with time. The best conditions for optimal results from radiotherapy occur when the serum PSA level is very low or undetectable, that is, in the true adjuvant setting. There is substantial evidence from nonrandomized series, almost unanimously in favour of ART for biochemical recurrence rates. There is robust level I evidence from well-executed randomized clinical trials reporting superior biochemical relapse-free and progression-free survival with early ART for patients at high risk for tumour recurrence. The previous argument that no overall survival has been demonstrated with ART has been invalidated by the recent results from a randomized controlled trial demonstrating that indeed there is overall survival advantage with ART compared with observation and delayed therapy. Thus the main criticisms and concerns regarding ART have been answered and there is convincing and compelling evidence to support the use of ART in patients at high risk of tumour recurrence after radical prostatectomy. Those patients at low risk for tumour recurrence should be vigilantly observed and at the first sign of biochemical or clinical failure, ART should be instituted to optimize treatment response.