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Salvage Radiotherapy?

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User
Posted 16 Jan 2026 at 09:16

Has anyone had salvage radiotherapy?

I had prostatectomy about 6 months ago. Went well. Good margins etc. But first two follow up PSA tests were 0.1 then 0.2. This triggered requirement for a pmsa pet CT scan. Results have come back clear. But I've been told I'll still need salvage radiotherapy. 

I've done some reading about it. But would be keen to hear of your experiences.

User
Posted 16 Jan 2026 at 13:58

Hi,

I had SRT (without HT) a couple years post surgery after my PSA started creeping up. Over three years on and my PSA is undetectable.. so far so good. 

I'm no doctor and my case is clearly different to yours, but I would want to ask some questions. 

Is there anything in your histology that might give a clue to where to focus the treatment?

Will your treatment be with or without HT?

How many fractions will your treatment be?

Hope this helps, 

Kev.

User
Posted 18 Jan 2026 at 17:21
My husband's RT was full pelvic region, 6 weeks. He walked 5 miles every day for his commute to the hospital and to work during the whole treatment even though he had bowel side effects. In case there is an option of public transportation, it could work. But I would recommend to plan to fill your bladder after you arrive at the hospital.
User
Posted 22 May 2026 at 13:50

Hi, Tony.

Press on their username and then please their view profile tab.

Edited by member 22 May 2026 at 13:53  | Reason: Typo

User
Posted 22 May 2026 at 18:46

Thanks Adrian 

User
Posted 17 Oct 2026 at 12:41

It's now 7 months or more since this thread started so I thought it worthwhile updating my progress. It might also help with timescales. I had my 20 sessions over 23 visits, 2 were aborted as I couldn't get my gas/bowels right and the other due to machine breakdown.

I've had three PSA tests since my treatments finished in February:

1. 0.2 ( same as before treatment but only 6 weeks after finish)

2. 0.1 (3 months after No 1)

3. <0.1(another 3 months later)

It looks as though the SRT has been successful and it's best not to get too anxious about early results as it takes time.

Things are good now, I feel healthy and well and we're just back from a 3 week trip to Bhutan and Nepal.

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User
Posted 16 Jan 2026 at 12:17

Please read my profile as I had it last year then happy to speak/message if it is helpful.

Best of luck. It is a kick in the teeth when you think you have dealt with it and it comes back (having never fully gone) but today I had a third PSA test since my Radiotherapy showing no cancer so there is light at the end of the tunnel.

User
Posted 16 Jan 2026 at 12:56
Check my profile also mate. I said no to it as my results were high and lymph nodes involved. As far as I was concerned the cancer had already moved on and wasn’t seen in my prostate bed via PET either. I’m in the 10 year club 😬
User
Posted 16 Jan 2026 at 13:18

🙏 Thanks.

Originally Posted by: Online Community Member

Please read my profile as I had it last year then happy to speak/message if it is helpful.

Best of luck. It is a kick in the teeth when you think you have dealt with it and it comes back (having never fully gone) but today I had a third PSA test since my Radiotherapy showing no cancer so there is light at the end of the tunnel.

User
Posted 16 Jan 2026 at 13:19

🙏 Thanks

Originally Posted by: Online Community Member
Check my profile also mate. I said no to it as my results were high and lymph nodes involved. As far as I was concerned the cancer had already moved on and wasn’t seen in my prostate bed via PET either. I’m in the 10 year club 😬

User
Posted 16 Jan 2026 at 13:56

I had the "educated guess" salvage RT three years after surgery. There was something in the bed because the PSA went down, but there was also something going on outside the bed because the PSA started rise after SRT. 

I have had two lymph nodes discovered and treated with SABR treatment about 18 months apart. Last year further spread was found and I went onto HT.

The SRT and SABR procedures have been successful in the treatment of what was targeted, subsequent scans showed the cancer in those detected areas was clear. Just be aware that as in CJs case, seeing nothing doesn't mean nothing is there. On my 4th recurrence a PSMA scan showed nothing, a few months later there were 5 hotspots. 

Thanks Chris 

User
Posted 16 Jan 2026 at 13:58

Hi,

I had SRT (without HT) a couple years post surgery after my PSA started creeping up. Over three years on and my PSA is undetectable.. so far so good. 

I'm no doctor and my case is clearly different to yours, but I would want to ask some questions. 

Is there anything in your histology that might give a clue to where to focus the treatment?

Will your treatment be with or without HT?

How many fractions will your treatment be?

Hope this helps, 

Kev.

User
Posted 16 Jan 2026 at 16:28

I had SRT in late 2024 following RALP in 2021. All details are in my profile. 

I wish you well. 

Peter

User
Posted 16 Jan 2026 at 19:25
Hi there, looks like we're in a similar situation, I had surgery in August 2024. My pre operation values were Gleason 7(4+3), N0, M0 and pt3a. This was increased to pt3a+ on histology as there had been some breakout to the capsule surface. First PSA was <0.1 (undetectable in my area, South Tees), then 4 at 0.1 followed by an 0.2. Not had a PET scan here but straight referral to oncology, followed by radiology.

Plan is the standard 4 weeks of 5 sessions/week delivering 55Gy. It's been a bit of a bummer but having a treatment plan, fully explained and validated by the oncologist makes the way ahead clearer and more acceptable, especially when I see what others here have said.

Due to start next Wednesday, good fortune to you too.

User
Posted 17 Jan 2026 at 06:14

Thanks for sharing . Hope all goes well.

Originally Posted by: Online Community Member
Hi there, looks like we're in a similar situation, I had surgery in August 2024. My pre operation values were Gleason 7(4+3), N0, M0 and pt3a. This was increased to pt3a+ on histology as there had been some breakout to the capsule surface. First PSA was <0.1 (undetectable in my area, South Tees), then 4 at 0.1 followed by an 0.2. Not had a PET scan here but straight referral to oncology, followed by radiology.
Plan is the standard 4 weeks of 5 sessions/week delivering 55Gy. It's been a bit of a bummer but having a treatment plan, fully explained and validated by the oncologist makes the way ahead clearer and more acceptable, especially when I see what others here have said.
Due to start next Wednesday, good fortune to you too.

User
Posted 17 Jan 2026 at 21:39

Hi, I was in a very similar position to you. 6 months after prostatectomy psa started to rise. PSMA PET showed nothing. Decided on SRT to the prostate bed as an educated guess. 20 sessions, last one was Christmas eve. SRT was started with a psa of 0.3. Got to wait 6 months now before next psa test so see if its been successful. To be honest SRT wasn't as bad as I'd feared, once you get into the daily routine it was ok. I think side effects have been less than after the prostatectomy. 

User
Posted 17 Jan 2026 at 22:48

Thanks Neil. Thanks reassuring. 

User
Posted 17 Jan 2026 at 22:54

All the best for next Wednesday 🙏

Originally Posted by: Online Community Member
Hi there, looks like we're in a similar situation, I had surgery in August 2024. My pre operation values were Gleason 7(4+3), N0, M0 and pt3a. This was increased to pt3a+ on histology as there had been some breakout to the capsule surface. First PSA was <0.1 (undetectable in my area, South Tees), then 4 at 0.1 followed by an 0.2. Not had a PET scan here but straight referral to oncology, followed by radiology.
Plan is the standard 4 weeks of 5 sessions/week delivering 55Gy. It's been a bit of a bummer but having a treatment plan, fully explained and validated by the oncologist makes the way ahead clearer and more acceptable, especially when I see what others here have said.
Due to start next Wednesday, good fortune to you too.

User
Posted 18 Jan 2026 at 13:54
Thanks, and the Thursday, Friday, Monday, Tuesday etc following for 20 sessions. I've been told that I get the full 4 week programme at the first session if that's of any help as information. Also two cars are registered for free parking during treatment - doesn't mean there's necessarily any space though at this Hospital.
User
Posted 18 Jan 2026 at 17:21
My husband's RT was full pelvic region, 6 weeks. He walked 5 miles every day for his commute to the hospital and to work during the whole treatment even though he had bowel side effects. In case there is an option of public transportation, it could work. But I would recommend to plan to fill your bladder after you arrive at the hospital.
User
Posted 26 Feb 2026 at 16:33
I am about to start salvage radiotherapy by SABR to deal with recurrent cancer on my prostate - 5 years ago I was treated with chemo, IMRT radiotherapy and ADT and it has returned still at Gleason 9 and going quick

I have decided on Salvage Radiotherapy rather than surgery - the surgery was not an option last time as it was spread to the lymph nodes also,

Not sure how it will go but lets see!!

has anyone had the SABR and what r the side fx like\?

User
Posted 22 May 2026 at 06:54

How do you see someone's profile on here. I'm confused. Thanks Tony. 

User
Posted 22 May 2026 at 13:50

Hi, Tony.

Press on their username and then please their view profile tab.

Edited by member 22 May 2026 at 13:53  | Reason: Typo

User
Posted 22 May 2026 at 18:46

Thanks Adrian 

User
Posted 17 Oct 2026 at 12:41

It's now 7 months or more since this thread started so I thought it worthwhile updating my progress. It might also help with timescales. I had my 20 sessions over 23 visits, 2 were aborted as I couldn't get my gas/bowels right and the other due to machine breakdown.

I've had three PSA tests since my treatments finished in February:

1. 0.2 ( same as before treatment but only 6 weeks after finish)

2. 0.1 (3 months after No 1)

3. <0.1(another 3 months later)

It looks as though the SRT has been successful and it's best not to get too anxious about early results as it takes time.

Things are good now, I feel healthy and well and we're just back from a 3 week trip to Bhutan and Nepal.

User
Posted 17 Oct 2026 at 14:50
There is some disagreement between Oncologists on how early to treat Possible PCa after surgery. Some make an educated guess as has been mentioned in this thread as sometimes the increase and rise over time can help indicate. Other Oncologists plump for treating the pelvis area. Yet other Oncologist want to wait for PSA to rise to a certain level, while some other leading Oncologists don't want to treat until Cancer can be seen on an MRI/PSMA scan.. The last way is generally the most accurate but risks treating after the cancer may have further spread or gained a stronger hold. Oh yes, consideration has also to be given as to whether there was clear margins at surgery.
Barry
 
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