SRT Starting, but PSA doubling

Personally, I am gobsmacked that you are not having hormone therapy with the salvage RT - not sure what research they are referring to but all the recent research is that the longer you have HT with the RT the more likely you are to achieve remission.

As you say, PSA tests won’t really tell you anything during the radiotherapy; you should hit nadir about 18 months later.

There is confirmed research now that with a PSA of under 0.7 SRT with HT provides no observed additional survival benefit or recurrence benefit than SRT by itself. This changes above 0.5 and significantly with a PSA of 1 of 2 and above. And thus starting HT if the SRT doesn't then work is their proposed method. Of course that would change if the PSMA noted any other lesions. Pls find link I saw on this too, and there are other studies similar to this in the US.

http://www.elsevierblogs.com/eururo/calculus-of-adding-adt-to-salvage-radiation-in-prostate-cancer/

I agree @ Chris J, on the QOL and glad you are maintaining this. I still feel as if I'm wandering into the unknown here, but that seems the case for many.  Thank you both for your comments, it really helps

Thank you @Old Barry. I had to pay since it wasn’t covered by my insurance but worth doing it And cheaper I believe than the Ga-68 tests.  The team doing this at Heidelberg are world renowned with developing these tests so Im grateful I had the chance to See what was happening. It just took a long time to schedule as there are many people doing this 

@LynEyre

Please look at the following link.  This is the American Society of Clinical Oncology

http://ascopubs.org/doi/full/10.1200/EDBK_200319

Here they give a fairly detailed review of treatment citing studies which might give you some broader perspective and why the UK and or other countries are choosing their ADT strategy, namely nothing is definite.

But I am concerned yes if I should be on ADT too, and only recently realised the UK strategy was so different so it is a worrying concern

On the Cialis part you are quite correct, there is little evidence to suggest that it adversely affects the PC, so yes for sure you would need to have a full-scale funded study to prove this and not recommend such drugs. 

Edited by member 16 Nov 2018 at 00:27  | Reason: Not specified

In UK it’s around £2600 at the very few facilities that offer it. I have read you can get one in India for around £500, so a trip to the Taj Mahal might be in the offing if I ever suffer recurrence!

Cheers, John.

Ruthinium is a good example. It is a ferrous uptake inhibitor or some such and works like chemo but only becomes toxic inside the environment of a cancer cell. Because it is a heavy metal in name though it is not getting the love it might otherwise deserve.

The talk also mentioned the use of crowd sourcing to fund research which was an interesting take.

First RT session yesterday and all went well for number 1. At least I didn't have a panic attack!, 34 to go now :-)  They told me in their planning they will use a higher boost for the PSMA identified area, and normal for the rest of the bed on each session.

i was reading previous comments about SRT and the group of people you meet.  Then I was reading some of the hospital advisory statements about how long each session takes.

When I started here, they gave me an exact slot and told to arrive then, drinking water on the way,Im thinking. I didn't see anyone patient wise really apart from the RO and the team doing the scans/RT and then when they made the next appointment it was for the next evening and then the following day in the morning.  They said it would settle down to a regular time slot in the next week.  But they run the sessions from 0700-2200 every day and they give you slots at 15 min intervals. So you are there for 15 mins and out.  I thought a little weird reading  some other reports such as where you drink the prescribed water when you arrive and then wait, perhaps with a group of other folks.  This of course sounds really German but it does sound a little different and very time-slot driven, or perhaps this is normal, who knows. 

Given I enjoy this through Christmas I get to come on Saturdays too due to the Xmas holidays taking 3 days.

The method of delivery is slightly different. I think Rich12 had tomotherapy.

I’ve scanned a few articles and think they are telling me (as you have also concluded) that outcomes are similar for tomotherapy and Rapidarc.

Others will hopefully come along and add to or correct what I have said.

Ian

Hi Pete

Thanks for asking. My last session is tomorrow, yayyy!  It hasn't been too bad actually side effect wise and a lot better than i thought it would be.  Having said that I wasn't on HT at the same time as you and others were, which probably made it a lot easier. I have been feeling tired more recently, especially after exercise and in need of a short nap - but nothing too bad, and with a little more frequency in the plumbing areas. I think I have more abdominal pains, which come and go and it sometimes feels as if someone has twisted your internals a little bit. Hopefully this doesn't get a lot worse in the weeks ahead following the SRT.  This SRT went through the Christmas period and New Year, and the hospital RT team shut down for 4 days over Xmas and 3 days over New Year (thats Germany for you), so I had to go on 3 of the Saturday's as well so it didn't make the breaks too long.

See the RT Oncologist tomorrow and then not sure when the first PSA test will be.  Living in dread of that of course, since you never know. Definitely taking a break or month off in February after this, although I think the Xmas break allowed me to manage this whole treatment more effectively travel wise and my family members came with me some days which made it a lot better.

Are you feeling better now and more back to normal? When do you have any of the further tests.  Hope all is well your side!!!