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CT Guided RT x6 recommended?

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User
Posted 31 May 2023 at 08:53

Hi all

I've recently finished my 6x Docetaxel chemo (3 weeks ago) and am continuing on Daralutamide.  I have surgical castration planned at the start of June so I can stop the LHRH implants, and then roughly 4-5 weeks after that I plan to start RT.

I have been put on the STAMPEDE trial to do CT guided RT at a private facility (Genesis care in Kings Hill, Kent).  It is described as 36Gy in 6 fractions (once per week) and the oncologist has specifically asked for Barrigel to help protect the back passage areas.

When I was diagnosed back in Dec 2022 I had the following:

PSA 990
Enlarged paraaortic and aortocaval lymph nodes (30x43mm), multiple bone metastases involving spine, pelvic bones, posterior acetabulum on the left
Bone scan  – uptake at C7, T1, T2, T3, left pelvis, right proximal right femur
Biopsy of paraaortic nodes – consistent with metastatic adenocarcinoma of the prostate

My last blood test PSA was 6.67, and I have another tomorrow along with my first CT scan to show progress after all the chemo.

Now I believe my diagnosis above translates to what they call low-grade stage 4 since the spread was only found in the pelvic/femur/spine areas and some lymph nodes around my lower back.  When watching the STAMPEDE trial videos they say it didn't show improvements for high-grade patients but did with low-grade.

Has anyone else here had experience of this type of radiotherapy and could tell me a little about how it went and whether overall it felt worth it for them?  I'm a bit concerned about side effects and QoL issues, but as usual probably worrying about stuff before I give it a chance.  I'm 51 by the way.

I'll post an update on my PSA and CT scan when I get that news back.

One positive thing I've heard this week is because of my diagnosis and subsequent conversations with friends and family recommending them to get checked, one friend of mine did that and found he had local PC after a biopsy followup from the PSA test and is now on the road to have that treated.  He is grateful to me and I'm glad he found it so much earlier than mine.

Rob

User
Posted 31 May 2023 at 21:22
I am not sure that your case could be described as low-burden metastatic PCa - low burden is usually 4 or less met sites and you have at least 6 bone mets + lymph node involvement. So it is great that they are willing to offer you the 6 X 6Gy treatment and who knows, it might work. If you are still here in 10 or 15 years, telling the tale of how you were involved in a trial that made a difference to future treatment regimes, that will be a win.

In terms of the 6 X 6Gy treatment, there are only a few men on here who have had that but all the data suggests that it is tolerated well.

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

User
Posted 25 Jun 2023 at 17:25

Hi Rob

I am not sure if it is exactly the same as yours, but I am getting weekly RT for 6 weeks (currently half way through) at the Royal  Marsden in Surrey. Next to no side effects so far and the oncologist said they would not expect any at my last appointment. I am not quite sure why I am on weekly and not daily, but will ask at my next appointment. I don’t know if any of the community know why some get weekly and some get daily. Mine is not intended to be curative, so maybe that is the answer. 

 

 
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