Plan B ADT and Salvage Radiation

User

Posted 05 Apr 2023 at 06:18

Please read my profile and prior post on Persistent PSA after robotic prostatectomy for T3a Gleason 7

[4+3] September 2022.

My PSA has been 0.7 to 0.6 post op and holding steady for last 4 months. PSMA PET, MRI pelvis and Bone scan all negative.

I finally saw the radiation doc and he said that it was a no brainer and very routine for me to have Salvage Radiation to prostate bed and to the pelvic lymph nodes. 33 treatments over 7 weeks with a total of 66 CGY. In addition Bicalutamide for 30 days and a shot of Lupron that would last for 4 months. No long term or 2 year ADT was recommended.

The radiation doc told me that the pelvic lymph node treatment in addition to the prostate bed was required to give the best outcomes according to the literature. I have to trust in his judgement and experience.

I will start SRT in mid May. I can't say that the design to go ahead sits comfortably with me. It has been a crappy year and Plan B was not in the cards. I am fearful of the SRT and the potential side effects. But I do not have much of a choice other than to go ahead.

Any thoughts or comments greatly appreciated.

User

Posted 05 Apr 2023 at 13:58

I start 8 weeks RT next week for similar recurrence. Good luck 🤞

User

Posted 05 Apr 2023 at 18:50

Very similar stats and journey to me SteveCAN. It is rather disheartening to recover from RP only to be hit with some more side effects seven months down the line. Unfortunately with a T3a diagnosis and a positive margin SRT was pretty much on the cards a some point. At least you can get things over with now and hopefully forget about the big C for a long time. All in all I found the RT/HT side effects a bit more tolerable than the RP side effects but everyone is different.

User

Posted 07 Apr 2023 at 18:48

Good luck Jellies with your radiotherapy treatment.

User

Posted 07 Apr 2023 at 23:46

I'm going to be very positive. I had salvage radiotherapy and 18 months of bicalutimide. Since finishing the SRT in June 2018, my PSA has remained at <0.006 - the lowest measurement my hospital's machine can give.

I was pT3b and Gleason 9 (4+5). Positive margins.

For me, the SRT and bicalutimide worked. I wish you similar success.

User

Posted 10 May 2023 at 23:23

Wishing you the best of luck with your treatment Steve 👍

User

Posted 28 Jul 2023 at 16:56

Hi Stephen, I can’t recall having too many problems with frequency of urination after salvage radiotherapy but I guess it will vary significantly between different people.

This will be due to your own physiology and the radiotherapy plan.

I hope someone with more knowledge answers your question more fully.

Ido4

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User

Posted 05 Apr 2023 at 13:58

I start 8 weeks RT next week for similar recurrence. Good luck 🤞

User

Posted 05 Apr 2023 at 18:50

User

Posted 07 Apr 2023 at 18:48

Good luck Jellies with your radiotherapy treatment.

User

Posted 07 Apr 2023 at 19:03

Chris, Like me you look like you enjoy hiking. You have had a crappy year and I wish you well on your recovery. Thanks for the words of encouragement and knowledge that others have been there before. I am just taking a day at a time.

User

Posted 07 Apr 2023 at 20:53

Thanks SteveCAN. Yes I do enjoy hiking and one of the frustrating things has been the impact this has had on my incontinence. Most of the time I get by with just an odd dribble but any prolonged walking results in pad changes about every seven miles or so.

User

Posted 07 Apr 2023 at 23:46

I was pT3b and Gleason 9 (4+5). Positive margins.

For me, the SRT and bicalutimide worked. I wish you similar success.

User

Posted 10 May 2023 at 21:34

Just an update, after much waiting I am finally booked for salvage radiotherapy, daily sessions starting tomorrow May 11th and end June 30th.

I am on 6 months hormone treatment and notice hot flashes at night, more headaches? and minor fatigue with some weight gain.

I am hoping to continue with a bit of afternoon golf during the early part of my radiation though that maybe a bit optimistic.

The plan is to move on later this summer and hopefully get success in treating my Pca.

User

Posted 10 May 2023 at 23:23

Wishing you the best of luck with your treatment Steve 👍

User

Posted 11 May 2023 at 01:17

Hopefully, you will be able to enjoy your golf all the way through treatment - John worked full time throughout and carried on with all his sports

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

User

Posted 11 May 2023 at 19:05

I had the first treatment today. I really hope that I can emulate John's experience with radiation treatment.

I plan to keep as active as possible.

Thankyou for the best wishes.

User

Posted 11 May 2023 at 20:52

As a fellow golfer (sometimes I qualify!) and having done 20 sessions of RT ... I reckon you will be OK for the first few weeks or so but may start to flag a bit (no intended golf pun ... honest!!! ) near the end. Hot Flushes/Fatigue are common with the HT but I didn't suffer any headaches thankfully. All the very best, its amazing how quickly it goes ! Cheers, Nick

User

Posted 12 May 2023 at 03:37

Thanks Nick for posting your detailed experience of radiation treatment. I will keep active everyday during RX and will watch for fatigue, bowel and bladder symptoms.

Who knows maybe my golf game will improve.

I will ask my oncologist why he is only planning 6 months of Lupron. Maybe there is a risk benefit paper somewhere?.Perhaps longer periods of hormone treatment with radiation are the norm in the UK and just different in Canada.

Edited by member 12 May 2023 at 03:38 | Reason: Not specified

User

Posted 27 Jul 2023 at 19:53

Just an update. I completed 37 Linac machine salvage Radiation sessions to prostate surgical bed and pelvic lymph nodes, this ended just under a month ago. I am completing 6 months of hormone treatment with Lupron.

I have persistent bladder symptoms, pain/discomfort on peeing and a need to pee every 2 hours or so.My sleep is disturbed by waking to pee. I am taking Detrol an antimuscarinic which initially helped decrease my bladder symptoms but is less effective. I have increased bowel gas but this is improving.

My question is does anyone have any idea how long the bladder symptoms may last? How normal is this?

Thanks Stephen

User

Posted 28 Jul 2023 at 16:56

Hi Stephen, I can’t recall having too many problems with frequency of urination after salvage radiotherapy but I guess it will vary significantly between different people.

This will be due to your own physiology and the radiotherapy plan.

I hope someone with more knowledge answers your question more fully.

Ido4

User

Posted 28 Jul 2023 at 19:00

Stephen, I did suffer a little bit with both frequency and urgency. I was getting up two to three times a night compared to the usual once. The urgency was treated with Solifenacin and after about four weeks or so both symptoms had gone. It did also affect my incontinence. That took around 3-4 months before it returned to what it was pre RT.

User

Posted 28 Jul 2023 at 19:08

Thanks. My bladder symptoms had been improving but recently increased. I have stopped /reduced coffee. I am waiting for a call back from my doctor [radiotherapist]. I am still continent.
I am looking forward to being able to sleep through the night and not plan everyday around the bathroom.

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