Radiotherapy & hormone therapy

Hi Lizzo,

My PSA levels were virtually un -recordable following surgery until 25/10/23 when it was recorded at 0.09 on 13/12/23 it was 0.1 on 20/02/24 = 0.20. On 27/07/ 24 the oncologist told me it continued to rise. Recommended at this point 33 sessions of radiotherapy and 2 years hormone therapy. Radiotherapy will target prostate bed and lymph nodes in pelvis area to sap micro cancer cells My wife and I were shocked it was 33 sessions. Stupidly we thought radiotherapy may have been one week. Hope this information helps. Best wishes. 

Unfortunately with a T3b staging (like me) you are at greater risk of recurrence. 33 fractions of EBRT tends to be the norm. The toing and froing to and from the hospital tends to be a bit of a drag but most people report a good experience during treatment. I was lucky in that I only had six months of RT but others, like you, are on it for two years. I'm not sure I understand the rationale behind six months/two years. The treatment is likely to cause bladder and bowel irritation which gradually goes away. You might be given Solifenacin for the bladder irritation and told to take Imodium if loose bowels are a problem. If you are seeing another doctor for your IBS it might be worth speaking to them.

I agree with J-B, with a short doubling time, you need to be treated.

The 30+ sessions is kinder to the surrounding organs than the shorter regimes of higher-powered treatments. While prostates handle the smaller number of higher power accurately aimed doses well, not all other organs do, and salvage radiotherapy after prostatectomy is by definition not targeting the prostate.

There is a product which uses a rectal probe during radiotherapy to live monitor rectal dose (I can't recall the commercial name), and might be of particular value in an IBS case. A Scottish hospital offers this, and maybe some others too, although it's not common. Another option might be an MR-LINAC to very closley monitor the rectal position during treatment, which a few specialist centres have now. Any of these could require that you are treated a long way from home, because their availability is limited. The more accurate targeting these techniques provide could also mean fewer higher powered radiotherapy sessions would be safe.