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Alternatives to radiotherapy

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User
Posted 19 Mar 2025 at 16:59

Hi, I am interested to hear from anyone in a similar situation to me who has had alternative treatments rather than radiotherapy. 

I had RARP surgery in Jan 2023 and at the time I my final histology was Gleason 4+3 adenocarcinoma of the prostate pT3aN0Mx. Focal R1.

Now 2 years later my PSA has crept over the 0.2 mark and I now have radiotherapy booked soon to target the prostate bed. It is not thought that my cancer has migrated outside the bed at this stage but I have an MRI booked imminently. I know I am having brilliant care at the Marsden hospital but I would like to hear from anyone who has been in a similar position to me but gone down an alternative path of treatment rather than radiotherapy after surgery? Pls can you let me know what that treatment was and how successful that has been? Thanks  

User
Posted 19 Mar 2025 at 17:59

I don't know of another mainstream treatment in this case.

There's life-long hormone therapy, but that's not a curative treatment and might eventually fail if you live long enough.

Another possibility is to have a PSMA PET scan, but with a PSA of only 0.2, it might not show anything yet. They might insist you wait until it's higher before booking a PSMA PET scan, and that does risk it spreading. If it does show something, it could be away from the prostate bed, and might be amenable to stereotactic radiotherapy. However, with the R1 (was it positive margins?), it's most likely to be in the prostate bed

User
Posted 19 Mar 2025 at 18:07

Thanks. Yes it was a positive margin. I have asked about the PET/PSMA scan as this was not offered to me but a nurse from Prostate Cancer UK queried this. The consultant said the same as you that the probability of it showing on PET scan is low and it is a timing issue of it showing up v spreading. Anyhow thanks for your response.   

 
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