Radiotherapy pros and cons?

User

Posted 25 Nov 2023 at 08:20

Morning everyone

I had a radical prostatectomy in 2016. All had been fine until the last 12 months when my PSA started rising. The rise in the last 2 months went from 0.08 to 0.11. I am aware that there is considerable debate as to whether the threshold is 0.1 or 0.2.
Anyhow, I had a consultation yesterday and the consultant has referred me to an oncologist at the Christie to discuss the pros and cons of having radiotherapy. Has anybody else faced a similar situation? Naturally it’s concerning having had a decent run of things these past few years. I’m 68 and otherwise in good health with an active life.

Thanks

User

Posted 25 Nov 2023 at 11:14

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

User

Posted 25 Nov 2023 at 11:23

Thanks Chris.

much appreciated and good luck.
Bazzag

User

Posted 25 Nov 2023 at 12:44

You had yours a year after me, I seem to have a similar length of time after surgery as mine touched 0.1 over a year ago before dropping a bit and now up to 0.11. I have a retest and consultant appointment in January, my Onco says leave it until 0.2. he has previously said treat at 0.1 but I think recent research has changed it to the more conservative approach.

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

User

Posted 25 Nov 2023 at 12:54

Hiya.

Thanks for your response. Maybe mine will follow yours in their action plan.

good luck with your forthcoming appointment too.

Bazzag

User

Posted 25 Nov 2023 at 13:47

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

User

Posted 25 Nov 2023 at 14:01

Derek

Hi. Much appreciated. Hope you’re keeping well too.

Bazzag

User

Posted 26 Nov 2023 at 00:31

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.

Dave

User

Posted 26 Nov 2023 at 06:35

Hiya.

Many thanks for your response. There’s much to consider.
Bazzag

User

Posted 27 Nov 2023 at 00:04

John was referred to oncology when his PSA reached 0.12 (2 years post-op) and it had risen to 0.16 by the time he saw the oncologist who put him straight onto HT with the salvage radiotherapy done 3 months later. That was 12 years ago so it was clearly the right decision at the right time!

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

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

User

Posted 27 Nov 2023 at 06:57

Many thanks Lyn much appreciated.

Having been referred by the consultant urologist to the oncologist is obviously the right way ahead.

Thanks again.

Bazzag

User

Posted 27 Nov 2023 at 18:05

Originally Posted by: Online Community Member

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%.

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.

User

Posted 27 Nov 2023 at 18:27

Many thanks

Bazzag

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