Meeting with radiation oncologist next week

What to expect??? Had my 2nd follow up since RALP in July. Follow up psa .02 in Oct. 15 and .04 last week. Urologist is concerned because of seminal vesicle invasion. Any similar experiences...advice?

Dx 51 years old
4/2015 normal digital exam
Psa 4.66

5/2015. Biopsy 5/12. Cores positive
Gleason 3+4 T1c

7/2015. RALP
Post-op pathology=T3b, pos. margins, SI involment

10/2015. Follow up psa .02
1/2016. Follow up psa .04

Post Edited (Dugalf) : 1/19/2016 5:36:59 AM (GMT-7)

Bummer. My PSA was zero post RALP but I had a positive node so I was a candidate for IMRT and hormone therapy, sounds like you need to follow in my tracks.

I just completed 33 sessions of IMRT (66Gy's) on Dec 30, looking back it wasn't that horrible, just a long haul. I was tired and needed to take an hour or two nap in the afternoons when I was getting a large dose. The radiation oncologist might also recommend ADT (hormone therapy) before radiation. The Lupron is another matter, it's the "gift that keeps on giving" hot flashes, etc. I'm anxious to get that out of my system. Good luck which ever way you proceed.

Dugalf,

Here is a link to a review of current research on the subject of earlier salvage radiation (SRT) than done in the past. This is written by
our forum member "Tall Allen" who hopefully will chime in if he is around.

I was also T3b. But after my open surgery in 2002 I didn't rise to 0.04 until nearly 30 months after surgery. I see your have hit this PSA level much sooner than I did. At the time, the medical consensus was to not pursue SRT until PSA reached 0.2 or higher. In my case that meant I did not have SRT until nearly 8 years after my surgery. The good news was my PSA remained undetectable for nearly 5 years after I had SRT in 2010. The less good news is I now again have detectable PSA and expect to need further treatment sometime in the future. If I'd had earlier SRT would I still be undetectable today? Who knows? But, given today's guidelines and my aggressive pathology, I'd have gone for earlier SRT if today's research was available then.
Jim
prostatecancerinfolink.net/2015/01/04/when-should-the-patient-and-doctor-consider-salvage-radiation-therapy/

Dugalf

Well you have got one less than rosey path report and a psa that is ticking up pretty fast. It would appear that you are headed for a recurrence. Yes, you need to be finding a RO pretty quickly and see what they have to say. You still have a chance for kicking the beast in the rear end for sure. I think you can ask all the questions that have been put forth here. Unfortunately, every person's response is different to the treatments. Some of us experienced a little tiredness at the end and that was it. Others catch the whole boat load of troubles. The sky is falling! You will be somewhere on the continuum, no real way of knowing where until you get there. I think it really depends on who is developing your treatment plan and who administers the treatments. Go to the best place you can afford and find. I had a great RO and team at MD Anderson in Houston. I have had two psa tests since completion- both <.006. Could not be more pleased with the results nor the decision to have the treatments. Hoping for the best for you.

Pre-op and post-op 3+4 = 7 Gleason

Have not been scanned yet, but lymph nodes taken at surgery were negative.