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radiotherapy question ...

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User
Posted 27 Nov 2023 at 17:35

just a question . do you have to be on the hormone injection a certain amount of time before you start radiotherapy?  my partner started the tablets end of September and the first  injection about a month ago . they said he is going to be having radiotherapy waiting for clinical oncologist appointment on the 4th December hopefully get more of a idea then I'm  just trying to gage a timeline regarding to Christmas  thanks 

User
Posted 27 Nov 2023 at 19:21
My experience suggests that if HT is doing its job an oncologistcan be happy to delay RT. Again, only my experience, it's preferable to have, in general, a low PSA for the RT to work best? I happened to have been on Zoladex for just on 12 months before RT tho my PSA started at 21 & the HT took it down& kept it down throughout & Oncologist was happy. I was diagnosed end Oct 15, started the HT route then. Had a TURP (part of prostate cut away to help urine flow which was quite poor&RT would have made it worse). Got married 27 Oct 16 started 37 sessions RT 1 Nov 16. I didnt specifically ask to delay RT etc, it was just suggested it'd be no problem as treatment working.

So RT can be delayed a fair amount of time if things are going to plan but it seems the it is preferable for PSA to be low.

Peter

User
Posted 28 Nov 2023 at 17:37

In the UK, you normally do at least 3 months on HT before starting RT (called neoadjuvant hormone therapy), but some oncos prefer 6 months providing that still leaves you with a reasonable amount of time on HT after RT (called adjuvant hormone therapy).

It may be more relevant how much your PSA has dropped before starting treatment, but in the UK we don't often measure PSA again until 3 months after radiotherapy.

I did ask for PSA test during the neoadjuvant hormone therapy, and consequently pushed out my RT to 5 months because I wanted to get my PSA down to 0.1 first. My onco was fine with this, but he said I can only delay RT while my PSA is still dropping at a good rate, and not longer than 6 months as he'd had someone who did this and PSA started rising before the RT, which then didn't work possibly because he was already castrate resistant.

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User
Posted 27 Nov 2023 at 17:49

I think it’s normally at least 3 months on HT before starting RT, however for various reasons I was on it for 9 months before I started my 20 sessions. I think it also depends on your PSA and grading.  My Onco liked PSA to be <1 before starting…mine was 0.9.

User
Posted 27 Nov 2023 at 17:59

yeah thanks when say ht do u mean the  tablets he has been on them for 3 months near enough  as they started him straight away .   I thought it would depend on the individual case . I just don't like to plan anything now  however we are meant to be going to the lakes over the new years 28th till 2nd  with my partners family..  I know in the grand scheme of things it's not that important but we was hoping to have a few days away with family now the horrible first waiting period is over . it would be nice . they have said no spread to bones or nodes phew  . althou it's just  escaped the prostate.  his psa was quite high thou at 78 so guess just have to wait and see what next appointment says on the 4th thanks 

Edited by member 27 Nov 2023 at 18:02  | Reason: Not specified

User
Posted 27 Nov 2023 at 18:10

I was on the tablets(to prevent a testosterone flare) for 4 weeks and the HT injections started 2 weeks after taking the first tablet.
I think your best bet would be to speak to your CNS(Clinical Nurse Specialist) if there’s something you’re not sure about? I assume you have been assigned one?

User
Posted 27 Nov 2023 at 18:13

Well he has 2 and they both said different things 🤷 😆

User
Posted 27 Nov 2023 at 19:21
My experience suggests that if HT is doing its job an oncologistcan be happy to delay RT. Again, only my experience, it's preferable to have, in general, a low PSA for the RT to work best? I happened to have been on Zoladex for just on 12 months before RT tho my PSA started at 21 & the HT took it down& kept it down throughout & Oncologist was happy. I was diagnosed end Oct 15, started the HT route then. Had a TURP (part of prostate cut away to help urine flow which was quite poor&RT would have made it worse). Got married 27 Oct 16 started 37 sessions RT 1 Nov 16. I didnt specifically ask to delay RT etc, it was just suggested it'd be no problem as treatment working.

So RT can be delayed a fair amount of time if things are going to plan but it seems the it is preferable for PSA to be low.

Peter

User
Posted 27 Nov 2023 at 20:01

thank you . 

User
Posted 27 Nov 2023 at 21:06
Your new year break should be fine - RT is commonly started 6 months after the HT was begun but, even if the oncologist wanted to get going earlier than that, if you explain that you are going away they will wait until you get back. Plus they wouldn't want to start RT just before a load of bank holidays.

Is he still taking the tablets even though his first injection was 4 weeks ago? If so, can you confirm the name of the tablet he is taking?

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

User
Posted 28 Nov 2023 at 15:31

the tablets were Bicalutamide . he's just finished them  as they said to to finish what he had already been prescribed  after he had his first injection which was 3 weeks worth . thanks that's useful to know . 

Edited by member 28 Nov 2023 at 15:33  | Reason: Not specified

User
Posted 28 Nov 2023 at 17:37

In the UK, you normally do at least 3 months on HT before starting RT (called neoadjuvant hormone therapy), but some oncos prefer 6 months providing that still leaves you with a reasonable amount of time on HT after RT (called adjuvant hormone therapy).

It may be more relevant how much your PSA has dropped before starting treatment, but in the UK we don't often measure PSA again until 3 months after radiotherapy.

I did ask for PSA test during the neoadjuvant hormone therapy, and consequently pushed out my RT to 5 months because I wanted to get my PSA down to 0.1 first. My onco was fine with this, but he said I can only delay RT while my PSA is still dropping at a good rate, and not longer than 6 months as he'd had someone who did this and PSA started rising before the RT, which then didn't work possibly because he was already castrate resistant.

 
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