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Adjuvant Radiotherapy !

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User
Posted 28 Sep 2019 at 15:38

Interesting article today in Daily Express and endorsed by PCUK and conducted at Royal Marsden , basically saying that adjuvant RT was no longer recommended and it was preferable to wait for positive indications of recurrence before RT commenced. It suggested after 5 yrs more people survived with Salvage than with Adjuvant , showing the dangers of RT full stop. 

User
Posted 28 Sep 2019 at 15:38

Interesting article today in Daily Express and endorsed by PCUK and conducted at Royal Marsden , basically saying that adjuvant RT was no longer recommended and it was preferable to wait for positive indications of recurrence before RT commenced. It suggested after 5 yrs more people survived with Salvage than with Adjuvant , showing the dangers of RT full stop. 

User
Posted 29 Sep 2019 at 11:31
That's what the press release said to, so the outcomes in relation to PC were within 1% but those who had ART had worse side effects than the guys who waited and had SRT.

No one is questioning the benefit of RT for those who need it the trials were about when the RT is best delivered.

My urologist told me ART doesn't allow incontinence and sexual function long enough to recover and tends to "freeze" recover at or below the whatever stage of recovery you have reached. I guess this trial backs up that view.

User
Posted 29 Sep 2019 at 15:07

Very interesting Chris. I was offered to take part in the Radicals trial after surgery but decIded against it. They still need to report on freedom from distant metastases so it might turn out that some men would still benefit from adjuvant radiotherapy.

Hope you’re well just now.

Ido4

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User
Posted 28 Sep 2019 at 23:45

useful to know, thanks Chris.

thala

User
Posted 29 Sep 2019 at 07:49
Is there a link Chris?
User
Posted 29 Sep 2019 at 07:51
User
Posted 29 Sep 2019 at 09:16
Thanks I’m not good with links lol
User
Posted 29 Sep 2019 at 09:41

My oncologist told me after my surgery that based on my pathology it was highly likely I’d need radiotherapy at some stage.  She was willing to do adjuvant RT, but told me she’d prefer to wait.  I didn’t have to wait too long as a year later a PSMA scan showed where the remaining cancer was lurking.  Interestingly, with adjuvant RT, she would have been going in blind and that area would not have been treated.  Apart from that though, for the first year post surgery, I did wonder if I had made the right decision.  This article is reassuring for those men who put off ART. 

User
Posted 29 Sep 2019 at 10:20

I'm sure, though, that more men survive who have had either adjuvant or salvage RT than who have had no treatment at all. RT is unquestionably a damaging procedure, but the benefits do generally outweigh the harm caused.

Chris

User
Posted 29 Sep 2019 at 10:57
It was also reported in the Telegraph. John’s onco was involved in a related part of the trial, where all men were offered adjuvant RT after RP and he told us that it was looking very successful so my guess is that it was only when they made the comparisons with men that hadn’t had ART that they realised.

The way it was reported in the Telegraph, the comparison wasn’t that men who had ART had worse outcomes at 5 years than men who had SRT ... it was that men who had ART did worse at 5 years than men who didn’t ... so I need to go and read the actual PR I think

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 29 Sep 2019 at 11:31
That's what the press release said to, so the outcomes in relation to PC were within 1% but those who had ART had worse side effects than the guys who waited and had SRT.

No one is questioning the benefit of RT for those who need it the trials were about when the RT is best delivered.

My urologist told me ART doesn't allow incontinence and sexual function long enough to recover and tends to "freeze" recover at or below the whatever stage of recovery you have reached. I guess this trial backs up that view.

User
Posted 29 Sep 2019 at 13:55
I guess it’s a no brainier that men who had ART or indeed SRT are likely to have worse outcomes then men who didn’t need either

Bri

User
Posted 29 Sep 2019 at 14:38

Yes of course but you wouldn't expect men who had ART as part of the trial (so regardless of their staging and pathology) to be more likely to have recurrence than the men in the control arm who had nothing (regardless of their staging and pathology). That's the complete opposite of what they expected to find!

Edited by member 29 Sep 2019 at 14:40  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 29 Sep 2019 at 15:07

Very interesting Chris. I was offered to take part in the Radicals trial after surgery but decIded against it. They still need to report on freedom from distant metastases so it might turn out that some men would still benefit from adjuvant radiotherapy.

Hope you’re well just now.

Ido4

 
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