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2nd recurrence question

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Posted Yesterday 2:05 AM (GMT 0)
In general, can anyone please tell me what are the chances of getting a second recurrence of Pc following open surgery and after radiation therapy following an initial recurrence? I cannot seem to be able to find any information on this matter.

HISTORY

With a psa of 4.61 and a lump felt on prostate, had open surgery in April of 2012. In May 2012, first surgical psa was <.064 . In October 2012 psa was.182 and in January 2013 psa was .396. I started hormone therapy immediately and by June 1213, the psa was again <.064. Remaining on hormone therapy, I began 39 sessions of IGRT/IMRT radiation to the prostate bed. Sessions finished in early November 2013 after a two week break due to side effects. Will be seeing my urologist on December 20.

Oh, yes my Gleason score is 7(4+3) and one positive margin.
Posted Yesterday 2:10 AM (GMT 0)
I am an example of what you are talking about, and we have several other men that had secondary recurrence. I had open surgery, had recurrence within 9 months. Underwent salvage radiation, and had secondary recurrence within 6 months of radiation. I am now dealing with advanced PC. My oncologists believes that I am dealing with a lot of micro-mets, but no longer in the prostate bed. Thus far, none have been large enough to be detected by scans, including PET/CT scans.

I was a Gleason 7, also with one positive margin, like you.

David
Posted Yesterday 2:10 AM (GMT 0)
There are formulas out there to figure your odds, but in very general terms it is usually around 50/50.


Tom
Posted Yesterday 2:30 AM (GMT 0)
Salvage radiation is effective in about 30% of the cases. If you go to the salvage radiation nomograms at MSK Or Hopkins and plug in your pre and post op stats you will get a more accurate probability of your particular situation. Salvage radiation is only effective if the cancer is still localized to the prostate or the bed.
Posted Yesterday 2:34 AM (GMT 0)
Hi Sanctuary

Here is the nomogram you are looking for. It calculates the probability of being recurrence-free 6 years after salvage radiation based on your specific data. I have some room for interpretation in my data - e.g., it asks if there waslymph node metastasis. I had an enlarged lymph node that was targeted as part of my SRT, but have no confirmation that it was enlarged due to PCa.

So far I am recurrence-free 3 1/2 years after SRT.

rcc.simpal.com/692O71
Posted Yesterday 3:25 AM (GMT 0)
I agree with JohnT's analysis of SRT. The odds are low, because often the remaining cancer is not located anywhere near the prostate bed. At the time of my SRT decision, the odds were given as 20%. It would be nice one day, if an accurate test could be developed so that men facing SRT could make a more accurate decision. Radiation is a lot to go through, and puts the body at risk, and its a shame to have to endure it if it could be proven that it wouldn't help in the first place.

David
Posted Yesterday 3:33 AM (GMT 0)
I am one of those.
See sig for dates.

I am on & off Lupron these days.
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