Husband's PSA up to 1.1 14 mo after RP. SRT? Advice?

Hi Frm,

I had salvage radiation (SRT) after the eventual failure of my surgery. Though, in my case I had about 7 years before I needed SRT. I don't think your husband's age should be a factor. SRT would be a typical next step at this stage, unless there is strong reason to suspect the cancer has traveled beyond the area of the prostate bed. While a bone scan might turn something up, it would be unlikely that a scan would see anything, given his still relatively low PSA. Also you should ask your doctors about supplemental hormone therapy during SRT and possibly for some months after. There are now many published studies that show that adding hormone therapy to the SRT significantly increases the likelihood of success.

As for cost, assuming you are in the U.S. isn't he covered by Medicare? If so, Medicare should cover the radiation treatment, less whatever he might be liable for as copays under Medicare -- which I think is potentially 20% if you don't have a supplemental "Medigap" insurance plan. If you have a Medigap plan in addition to Medicare plan or are on a Medicare Advantage plan most of your costs should be covered.

I had my SRT before I retired and went on Medicare. My employer's Aetna medical plan covered the cost of the treatment other than $3,500 I had to pay, which was the plans maximum "out of pocket" cap, after which the insurer paid everything else.

Please give statistics similar to the ones you see be low the other posts if you do not know how to use signature just post them under "pst reply". But welcome . I will say this I would bypass radiation, and wait til the psa gets in to the 20-25 range , which it may never do in his life time. Avg time for Metastazation is 8 years according to a leading expert, Walsh. His may never get there in his normal life time even if its 20 years more. If it does, hit it,with HT or whatever is better by that time. Some studies have shown little change in morbidity{death} tween those who treat with HT early or late. Others say the opposite. I'll say this SRT,IMO, as is every word here, the biggest crapshoot outside of Vegas. and the honest Rad Oncologist will agree if you press them.

I don't think the scans would show anything, but they are typically done before undergoing a secondary treatment.

I had surgery, and it failed within months, then I had salvage radiation, and not only did it fail within months, it was administered wrong and I was severely damaged from it, enough to leave me 100% disabled.

The real question, is where is the remaining cancer located? Even most RO's are only guessing at best. If the cancer is in the prostate bed, then salvage radiation has a pretty good shot at being curative.

With your husbands age, one would have to weigh out quality of life issues vs. quantity of life issues, considering the high failure rate of salvage radiation, and him being his age, I think it could be a problematic choice in my opinion.

David