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Scan/Radiotherapy after RARP

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User
Posted 28 Aug 2025 at 15:16

Hi Everyone

It's now been just over 12 months since I had my RARP. Everything went well and I feel fine.

Latest PSA test was 0.26 which breaks the upper limit of 0.2 in my treatment area. Looks like next step is a scan followed possibly by radiotherapy.

I'd be glad to hear from anyone here who has been through the same experience.

Regard

LEN

 

User
Posted 28 Aug 2025 at 16:21
Several on here have been through it successfully...
User
Posted 30 Aug 2025 at 11:04

Hi Len. I reached 0.2 three years after RARP. My onco did not believe a scan would be conclusive at that low level and recommended a broad brush approach of RT to my prostate bed and pelvic lymph nodes. I completed 33 sessions of RT last November and started a two year course of Decapeptyl ADT which I intend to cut to one year due to unpleasant side effects (joint ache, joint movement restriction, hot sweats) and lack of evidence that two years is really required. Plus the fact that if I completed two years of ADT, I wouldn't really know if the treatment was successful for at least one further year until the Decapeptyl had completely exited my system (according to a very respected PCa consultant). The RT did affect my continence a little and left me very fatigued; I also experience greater urgency and occasional burning sensations down below, but I am beginning now to feel some improvement and hopeful these things will gradually resolve.

Best of luck with your decision making and any treatment you may choose. 

Peter

User
Posted 30 Aug 2025 at 13:15

Hi Len, yes I'm in a very similar situation to you. Prostatectomy April 2024, all results good until Jan 25 then increase to 0.1 then in Feb 0.2. At the moment it's stayed at 0.2. Had a PSMA pet scan a few weeks ago, and to the consultant's surprise, the cancer wasn't highlighted. She said nowadays the scans are so good it usually shows at 0.2. She's given me the option of 20 sessions of RT to prostate bed as a best guess at hitting it. However, it's only a guess. She didnt think HT was needed. I've been left to make the choice and don't know which way to go. Ie wait for a psa increase and have another scan (self funded as nhs would only pay for the one) to try and identify and target the cancer or give the prostate bed a blast. Obviously RT can cause its own long term and short term issues and may not even hit the spot!! It's a difficult decision to make as I'm worried about leaving it too long and it spreading further.

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User
Posted 28 Aug 2025 at 16:21
Several on here have been through it successfully...
User
Posted 30 Aug 2025 at 11:04

Hi Len. I reached 0.2 three years after RARP. My onco did not believe a scan would be conclusive at that low level and recommended a broad brush approach of RT to my prostate bed and pelvic lymph nodes. I completed 33 sessions of RT last November and started a two year course of Decapeptyl ADT which I intend to cut to one year due to unpleasant side effects (joint ache, joint movement restriction, hot sweats) and lack of evidence that two years is really required. Plus the fact that if I completed two years of ADT, I wouldn't really know if the treatment was successful for at least one further year until the Decapeptyl had completely exited my system (according to a very respected PCa consultant). The RT did affect my continence a little and left me very fatigued; I also experience greater urgency and occasional burning sensations down below, but I am beginning now to feel some improvement and hopeful these things will gradually resolve.

Best of luck with your decision making and any treatment you may choose. 

Peter

User
Posted 30 Aug 2025 at 13:15

Hi Len, yes I'm in a very similar situation to you. Prostatectomy April 2024, all results good until Jan 25 then increase to 0.1 then in Feb 0.2. At the moment it's stayed at 0.2. Had a PSMA pet scan a few weeks ago, and to the consultant's surprise, the cancer wasn't highlighted. She said nowadays the scans are so good it usually shows at 0.2. She's given me the option of 20 sessions of RT to prostate bed as a best guess at hitting it. However, it's only a guess. She didnt think HT was needed. I've been left to make the choice and don't know which way to go. Ie wait for a psa increase and have another scan (self funded as nhs would only pay for the one) to try and identify and target the cancer or give the prostate bed a blast. Obviously RT can cause its own long term and short term issues and may not even hit the spot!! It's a difficult decision to make as I'm worried about leaving it too long and it spreading further.

User
Posted 30 Aug 2025 at 17:28

Hi Guys

Thanks for the time to share your experience.

My PSA has been increasing rather rapidly from 0.1 in April this year to 0.26 in August. Likely cause cancer cells I think.

Next step for me is to have a scan and then decide from there. Hopefully the scan will show something that can be targeted.

Never a dull moment with this little bugger!!

 
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