Radiotherapy pros and cons?

Bazzag, at my hospital 0.1 brings you back under the care of urology and for me that meant more frequent testing. At 0.2 plans and discussions were made for salvage RT. Back in 2017 PSMA scans were not that common before SRT. My PSA drop for a while after SRT but slowly began to rise a a few months after SRT. I have recently had further radiation treatment to some lymph nodes. 

Thanks Chris 

This approach was confirmed by a second option at the Royal Marston (wait until 0.2).

Hi Bazzag,

Having been through RT(not SRT) I wouldn’t worry too much about it. However if you can avoid also having HT I would 100%. Some people seem to have few side effects but for many it’s a real rollercoaster ride!😟

all the best,

Derek

I wouldn't disagree with Derek, but I wouldn't be quite so definitive at avoiding it 100%, I'd say avoid it about 80%.

With SRT, HT is often not required. If it is suggested then it is often for six months, whereas with RT it is often for two years. The benefit of HT in the few months either side of RT is (considered to be) fairly high, the benefit going beyond twelve months less so. If the onco mentions HT I would accept it for six months, and then if the side effects are troublesome stop it.

The guideline is to refer to oncology when:

- PSA reaches 0.2, or

- there are 3 successive PSA rises above 0.1, or

- PSA rises above 0.1 and there was a negative pathology report

Being referred at 0.1 / 0.2 doesn't necessarily mean that the onco will act immediately but better to be under their care and being monitored than to have a urologist who delays referral

Yes, sorry Dave is right here, a shorter course of HT is probably ok. Yes, you might get some hot flushes and the obvious side effects of ED(surprisingly I’m not too bad in that dept😉😉) and lack of libido(Oh yes!🤣🤣🤣). My real problems with HT started after a year on it with joint ache/stiffness being by far the worst side effect.