SRT

I can only tell you what my Uro told me. When my PSA went from undetectable to .1 to .2 he said if there is an increase the next time then SRT would need to start because of recurrence. He defined recurrence as three straight increases in PSA after surgery. When my PSA hit .3 I had 33 sessions of radiation. As far as side effects, I did have bouts of diarrhea but fatigue was the worst of the side effects. There are other side effects and others can relate their stories. Hope that helps and good luck!

hammer

Based on the guidance I had from my uro, RO, and what I read at the time of my SRT nearly 5 years ago, a PSA of .2 after surgery
is considered the indicator that you are in biochemical recurrence and that further treatment will be needed. It is then up to you and your doctors to decide if SRT is the appropriate treatment. Studies show that SRT is likely to be much more effective if delivered before PSA reaches 0.5.

In my case, side-effects were transient and fairly moderate. about halfway through the treatments I began to experience urinary urgency when first standing up, but it was manageable and would recede within a minute or so once I focused on willing it into submission. The urgency receded by about a month or so after completion of treatments. Though I still get occasional urgency (maybe a couple of times per month), even without a lot in my bladder, but nothing I can't control until finding the nearest men's room, and I can't say for sure this is any worse since SRT than it was from my original surgery. I also get occasional leakage, especially if I have a cold and am coughing or sneezing a lot. But again am not sure this was worsened by SRT.

My only other SE was rectal bleeding which began about 8 months after treatments. This was intermittent -- sometimes several times per day, sometimes only every few days. This gradually improved over the course of a year until it disappeared other than occasional spotting.

Many here also report fatigue as a SE during SRT, but I did not have any problems with fatigue. I worked full-time throughout my SRT but worked at home. Fortunately I was in a job where I often worked at home via VPN, conference calls, and company laptop, etc. (unfortunately I had this home office capability because of the frequent need to extend workdays into nights and weekends). I could have gone to the office throughout treatment if necessary, but the logistics would have been a problem because the hospital was 12 miles to my west and the office was 30 miles to my east. So it made much more sense to work at home rather than spend extra hours driving in traffic. I was able to schedule my sessions for 8:00 or 8:30 a.m. so I could normally be at my desk by 9:00 or so.

Jim

The most important factor is to ensure you are completely continent before starting SRT.

If you have any level of incontinence and undergo SRT then it will not improve, and in fact is likely to get worse.

I was 95% continent (1 precautionary pad per day) when I started RT and within a couple of months I reverted to full incontinence and have not improved at all. That was over 9 months ago.

I was warned this could happen, but was too keen to get those cells before they could escape the pelvic region. Big mistake.

Good luck

Chas

hammer44 said...
i would to hear from anyone that know the side effect from SRT and when should you have it .before a psa reading 0.20 or after a reading of 0.02 .

Per their most recent joint guidance, the American Urological Association and the American Society for Radiation Oncology recommend that SRT be considered after two consecutive readings of 0.2 (not 0.02)

http://www.auanet.org/common/pdf/education/clinical-guidance/radiation-after-prostatectomy.pdf