Biochemical recurrence?

Hi Jacey,
with PNI and a positive surgical margin, I am impressed that you held out for two years rather than just go straight for the adjuvant RT/HT straight away. My husband also held on for two years before accepting that he needed further treatment. He had only 6 months HT because he coudn't bear some of the side effects but three years later is still in the happy place of a PSA hovering at 0.03 - 0.04 so all is looking good.

Are you sure about the 46Gy? 6 weeks would be 30 fractions which are normally at least 2Gy each. John had 20 fractions (4 weeks) at 3Gy as part of a trial and had no problems.

Hi Jacey

I can see it is 9 months since your RP. Looking at your profile I guess it is understandable why adjuvent RT wasnt offered.

It does seem as they are now taking the right course of action and hopefully the RT will sort out any remaining cells in the prostate bed.

Take care

Bri

My apologies, I misread your timings. So soon after the op, I think the debate about whether you are embarking on adjuvant or salvage treatment is pure semantics and, as you say, results are usually very good. Statistically, anyone who needs any kind of salvage treatment is less likely to achieve total remission but the 10 years disease free stats for Europe are good.

As for the Gys, primary RT for prostate cancer is routinely given as 37 fractions of 2Gy. Adjuvant or salvage RT can be for 37 fractions or fewer, commonly 19, 20 or 21. Until recently it was believed that 2Gy was pretty much the highest dose a man could take but there have been a couple of trials - one looking to find out how high a dose can be given safely and the other to see whether side effects are better or worse with higher dose. As I said, John had 20 sessions at 3Gy and sailed through. The onco has told us since that the trial data is suggesting that the higher dose actually reduces side effects. I don't know how high they went although there was someone on here getting 2.8Gy - Bri maybe?

What was really interesting (and nothing to do with the trials) was the reading I did around the 20 sessions. I was a bit worried that he would not do so well if he was only getting 60Gy when other men get 74Gy or whatever. However, radiotherapy has a cumulative effect, in other words the 60gy delivered in high doses over a shorter time accumulates to be the equivalent of the 74Gy over a longer time. Clever stuff, isn't it!