Worried over side effects

John had salvage RT / HT 6 years ago - or possibly longer. He had no side effects from RT and never missed a day's work, carried on playing rugby and going to the gym. He is just now starting to see some delayed ED issues; he can get an erection but is starting to find it more difficult to sustain erections for a long time. Otherwise, it was a breeze.

The HT was a different matter; he hated it and stopped early (6 months).

Depending on whether your PSA was good and low post-op and has only risen subsequently, you are displaying a classic trend for cells left in the prostate bed and I can see why there might be resistance to giving you fancy scans on the NHS. If on the other hand, your PSA has never been undetectable, a PSMA or Gallium 68 scan might be really useful.

 Steve, like Lyn I am surprised your PSA has been allowed to reach this level before suggesting SRT/HT. 

Your recurrence does appear to fit a pattern of local cells in the prostate bed but i personally would ask for a bone scan and an enhanced MRI to check things out.

 A PET scan would be appropriate too but would unlikely be funded.

I have been through prostatectomy, SRT and am finishing 27 months of HT.

The side effects are significant for me and for many others I’m sure and my recurrence fits a different pattern. But despite that i went ahead with a final curative attempt as that was my choice(and my wife)

Your PSA is increasing so you  can either choose not to do anything about that with QOL a priority over time or you tackle it with SRT, HT, or both to possibly extend life.

At 61 and with a rising PSA i would think very carefully about what you do.

If you do decide to have treatment the quicker you get started on HT the better.

Not an easy choice, none of this is.

Ian

Unfortunately, a small number of men, like our member Chris, do not show clearly where their cancer is on advanced scans or even on pretty standard ones in some cases. This of course makes it very difficult to know where to aim RT. Quite often this is directed at the area in and around Prostate Bed as being the most likely affected area though not definitively. It follows that the earlier salvage RT of one type or another can be accurately aimed, the better the chance of it stopping spread and gaining heterogeneity. I agree it would make sense to discuss with an Oncologist what scans might be helpful to possibly show and then treat any cancer found.

Edited by member 22 Jan 2019 at 21:05  | Reason: Not specified

Sorry i asked why psa was allowed to reach that point, no distress intended just trying to help. 

Ian

Thanks Bri, sometimes the written word can come across differently than intended. When I was working in my school this happened many times with emails so I know exactly what you mean.

I hope your PSA is remaining undetectable and that you are well too.

Cheers,

Ian