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8 years on...next steps

User
Posted 21 Jan 2021 at 16:55

Following a G9/T3 diagnosis almost 8 years ago, I had surgery followed 2 years later with salvage RT. My PSA has been on the rise with an increase from 0.44 to 2.7 last year although I haven’t started HT.

I have just had clear bone and CT scans which is a huge relief, and my oncologist is recommending a PSMA PET scan possibly followed by stereotactic ablative radiotherapy (SABR) if something is identified by the scan. I realise that I’ve had a good run and lucky to be considered for this further treatment.

I’m not sure what to expect from this treatment (single blast of SABR or multiple sessions similar to salvage RT) and if it’s carried out with curative intent or control/disease management. I would appreciate any comments from those with insight or experience of this treatment.

Many thanks.

User
Posted 21 Jan 2021 at 18:58

Andrew,

My understanding is it's carried out with curative intent, but with the knowledge that the curative success rate isn't high.

However, even when it doesn't cure, it can significantly push back the next level treatment, and I guess NICE considered that's still a worthwhile increase in quality adjusted life years for the cost of the procedure.

You should be able to get your oncologist to confirm if my understanding is correct.

I believe this is something Mount Vernon (and other centres outside the UK) was offering experimentally, and it's relatively recently it's been recognised by NICE for treating up to 3 mets which have been found after previous curative treatment followed by recurrence. (The trial allowed up to 5 mets.)

User
Posted 22 Jan 2021 at 02:29

Like so many many things with PCa this treatment can work well or for a time for some men. The PSMA scan can show locations where cancer has spread if these are sufficiently concentrated. Unfortunately, the scan sometimes does not show cancer cells if they are not sufficiently condensed or if a patient does not express sufficient PSMA, the latter being applicable to about 8% of men of which one of our regular contributors Chris is one.

You might find it helpful to search through the Profile/Bio and conversations of our member Roy who had SABR, as he may not see your post. https://community.prostatecanceruk.org/default.aspx?g=profile&u=12848

 

 

Edited by member 22 Jan 2021 at 02:33  | Reason: to highlight link

Barry
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User
Posted 21 Jan 2021 at 18:58

Andrew,

My understanding is it's carried out with curative intent, but with the knowledge that the curative success rate isn't high.

However, even when it doesn't cure, it can significantly push back the next level treatment, and I guess NICE considered that's still a worthwhile increase in quality adjusted life years for the cost of the procedure.

You should be able to get your oncologist to confirm if my understanding is correct.

I believe this is something Mount Vernon (and other centres outside the UK) was offering experimentally, and it's relatively recently it's been recognised by NICE for treating up to 3 mets which have been found after previous curative treatment followed by recurrence. (The trial allowed up to 5 mets.)

User
Posted 21 Jan 2021 at 23:25
John's onco hopes that this will be our route if and when the PSA rises again. Curative intent but with no promises.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 22 Jan 2021 at 02:29

Like so many many things with PCa this treatment can work well or for a time for some men. The PSMA scan can show locations where cancer has spread if these are sufficiently concentrated. Unfortunately, the scan sometimes does not show cancer cells if they are not sufficiently condensed or if a patient does not express sufficient PSMA, the latter being applicable to about 8% of men of which one of our regular contributors Chris is one.

You might find it helpful to search through the Profile/Bio and conversations of our member Roy who had SABR, as he may not see your post. https://community.prostatecanceruk.org/default.aspx?g=profile&u=12848

 

 

Edited by member 22 Jan 2021 at 02:33  | Reason: to highlight link

Barry
User
Posted 22 Jan 2021 at 08:06
Great news the NHS is offering this, fingers crossed the scan finds something that is "blastable"
 
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