Radical treatment query

Ann, sorry the two of you are facing this.

It sounds like your urologist thinks oncology may be prepared to treat the prostate, seminal vesicles, and lymph nodes with radiotherapy, and they might also treat the one bone spot at the same time, or afterwards. This is sometimes offered if there are no more than 3 small bone mets.

Chemo would be done usually a month after starting hormone injections (which in turn is roughly 2 weeks after starting Bicalutamide). The radiotherapy is then typically done after the chemo. RT is best delayed in any case until the hormone therapy (and chemo in this case) have had a good time to act - it's more effective when the cancer has already been knocked back by HT and CT.

If patients are not having CT, then they do HT for 3-6 months before starting RT. (The HT before RT is called neoadjuvant HT. The HT after RT is called adjuvant HT.)

I think CT at this stage is usually 6 cycles of 3 weeks each, i.e. 4½ months, so I think your RT will be around 5½-6 months after starting HT if the CT starts a month after HT, but that timing isn't critical. For some cancers, the RT is given during CT, but I don't think that's done with prostate cancer.

Thanks for the comments. I've recently been asked to teach a class to therapeutic radiography students at University of Suffolk too, but do bare in mind I'm a patient, and not a clinician, so do check this with your oncologist.