The Next Step

So I had RARP in August, and the followup PSA in October was 0.13 - not what I had hoped, but better than 34.2 in May.

Met with the Radiation Oncologist last week, and I'm scheduled to meet with the Medical Oncologist in December to start ADT - probably for 2 years. Then Radiation simulation in mid January, and start IG IMRT in late January or early Feb.

I don't know the dosage for pelvic floor or lymph nodes yet - The RO thought about 70 Gy for pelvic floor and somewhat less for lymph nodes if I remember correctly. He will determine fractions after the CT simulation.

Can't say I'm really looking forward to this, but I guess it beats the alternative.

Rob

HardlyRob-

It sounds like you have a good RO. Yes, doses of 70 Gy or even higher for the prostate and doses of around 50 Gy or higher for the pelvic LNs are common. And long-term ADT makes sense, given your positive LN. Of course, you have to start treatment immediately. If you haven't yet regained urinary function, you can coast for a while on ADT before the radiation starts.

Thanks guys;

I get another PSA in the end of January, and meet with the Uro on Feb. 2. But I will already be on ADT, so I don't really know what the PSA will tell us.

He was pretty adamant (and there was a recent paper to back it up) that waiting on ADT / RT for node positive guys isn't really an option regardless of post surgery PSA. Based on reading the paper, I agree with him.

Thanks for the confirmation on typical pelvic floor and lymph node radiation doses - that matches what I've read elsewhere.

I'll keep y'all posted, and best of luck to everyone else out there.

Rob

Got it - Thanks Tall Allen

Rob