RT post RRP

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User

Posted 07 May 2019 at 20:25

Hi All,

I was Gleason 9 and had an RRP in September 2018. Cancer was mainly contained but there were a few marginal areas. My Doc did not feel I needed RT right away, and suggested we just keep an eye on the PSA. It showed less than 0.03 in December, but in February it had ticked up to 0.05 and by April 0.06. He now feels I should have pelvic RT sooner rather than later due to the aggressive nature of my cancer at the outset. I am not yet sure if I will need hormone treatment prior, or if I will go straight to RT. There is little evidence that hormone therapy does much good when there are only a few cells lurking about. Has anyone been through a similar experience and would you have any advice for me?

Many thanks!

User

Posted 07 May 2019 at 22:34

Very similar to me, except I’m a lot younger than you. A year or so after my surgery, I started on hormone therapy in preparation for 33 sessions of radiotherapy. If I were you, I’d be fighting for the HT. I don’t know if age was a factor in my case. I also paid for a PSMA scan prior to radiotherapy. It usually doesn’t work when PSA is very low but thankfully in my case it did show where the cancer cells were lurking. I finish HT in August - a total of 18 months. It is not a nice treatment in my experience, but I have no regrets either.

ulsterman

User

Posted 07 May 2019 at 23:14

I have not researched HT for your situation, only as a neoadjuvant and adjuvant therapy for when RT is the radical treatment, which is what I'm having.

However, it does two things:

Reduces prostate and tumor size, for when that makes the radical treatment easier (not relevant for you now), and,

Prevent cancer cells multiplying so you are hitting them in two ways together when having RT, and thus more likely to completely kill them.

I would have thought the second was still relevant, and not related to the number of cells existing, but like I said, this isn't a case I researched for my own treatment.

Edited by member 07 May 2019 at 23:16 | Reason: Not specified

User

Posted 08 May 2019 at 16:03

It’s a difficult call to make but with Gleason 9 I would be asking the question.

There are no specific guidelines on treatment for recurrence but a body of evidence is building to show HT plus SRT provides better outcomes.

My recurrence in 2016 had an initial doubling time of less than 2 months so my oncologist put me on HT 3 months prior to SRT and for almost 2 years post SRT.

See report from this link.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5845289/pdf/12885_2018_Article_4189.pdf

Edited by member 08 May 2019 at 16:04 | Reason: Not specified

Ido4

User

Posted 08 May 2019 at 17:26

This is very interesting - and helpful. Thank you!

User

Posted 08 May 2019 at 17:54

You are very welcome. Have a read through my profile too if you have time. It may be helpful.

All the best.

Ido4

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