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Is there a sticky for guidiance for salvage radiation options

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Posted 9/5/2017 3:20 PM (GMT 0)
Anyone know a good thread or is there somewhere to read options around salvage radiation?

My score 10 months out went from 0 to 0.05 to 0.07... and im wondering should i really consider ADT. Does this quick rise suggest metastatic cancer?

Is cyberknife a possible approach... etc.

Looking for all help and info tht could help me discuss iptions with RO...

Also, would a bone scan/ or any other can of scan help me?
Posted 9/5/2017 4:57 PM (GMT 0)
you could do a search for "salvage radiation" or SRT in the forum. Lots of posts on the subject.

IMRT is most often used for SRT. The rise could be from any number of causes. Scans at this point are unlikely to show anything as that is a very low PSA number. It may or may not be metastatic.

ADT is often used in conjunction with SRT to weaken any remaining PC cells and make SRT more effective.

I'd suggest a PSA retest in a few weeks to confirm the rising pattern.

Andrew
Posted 9/5/2017 6:55 PM (GMT 0)
Are the dates right on your PSA tests? If so, it just tells you that there's normal variation in PSA output. It absolutely doesn't indicate metastatic cancer.

I think most ROs would not give you adjuvant ADT with your low Gleason score and low PSA.

Chris King tells me that he has developed an experimental protocol that is in IRB review. They have to approve it before he can start clinical trials - it may be some time. The standard of care is about 35 treatments of IMRT with doses at or above 70 Gy (UCLA and MSK use 72 Gy)

Scans are pretty useless at your PSA. Even the best PET scans can't detect anything when PSA is that low. You just assume it's only in the prostate bed, which is where it almost always is at first.
Posted 9/7/2017 6:46 AM (GMT 0)
Thanks InTheShop and TA

It seems that I'm in holding pattern for a few weeks to see if this is a trend or not.

@TA -- yup dates are right... the RO I saw today sounded indifferent with adjuvant ADT.

Also, the study you mention TA --- what is it? is that a SBRT for Salvage Study?

Any studies that show damage from SRT due to starting too early at under 0.2 PSA and under 50 yr old...

My ED is already bad, any reports that SRT makes things better? ... my RO today said that there was 1 guy he had that had SRT and it make his ED better... weird.
Posted 9/7/2017 11:07 AM (GMT 0)
Two urologists and an RO told me that with a low psa, ADT is not helpful in conjunction with SRT.
Posted 9/16/2017 9:59 PM (GMT 0)
I had a PSA of .048 when I had my SRT. My PSA fell into the "unstable" category according to a study I can't find a link to now. Basically, the study indicated patients like me had a 35% probability of not progressing to metastasis if they were not treated.

Here is an examination of records that shows up to 4 fold better outcomes for "very early salvage radiation":

https://pcnrv.blogspot.com/2016/09/very-early-salvage-radiation-has-up-to.html

If you do decide to have SRT, the skill of the RO is critical to success while minimizing side effects since the prostate is gone and there is no prostate tissue to shield the colon or bladder.

Dr. Dattoli in Sarasota FL treated my prostate bed and lymph nodes. He uses color doppler ultrasound that located suspicious blood flow where my urethra was stitched back together (probable PCa). He also identified two lymph nodes that were larger than the others through a CAT scan.

Break60 calls Dr. Dattoli a genius. I concur. I highly recommend you call his office and schedule a FREE phone consultation.

http://www.dattoli.com/
Posted 9/18/2017 2:43 PM (GMT 0)
Thanks so much for this information...

Is a Color Doppler Ultrasound something that is standard procedure for a lot of RO's doing SRT?

I'll start asking my RO's that I'm interviewing down here in austin...

Zzarth
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