Radiotherapy and recurrence

User

Posted 27 Jun 2026 at 19:28

Hi,

I was just wondering if anyone has experience or knowledge of what happens if primary radiotherapy SABR/EBRT treatment fails after a few years and cancer reoccurs. It's my main concern for selecting radiotherapy as my primary treatment despite wanting to go down this route for my particular diagnosis.

My doctors have said it's very dependant on where and when the cancer reoccurs which would determine the possible treatments, but it's not as straightforward as when surgery is the primary treatment. I have read up on this but nothing like real life examples and so far I've found speaking to people along with these forums at PCUK so unbelievably useful in easing my fears around certain aspects of this vile disease...

many thanks if anyone can help

User

Posted 27 Jun 2026 at 23:46

I agree with what your Drs have said. If after RT it is established that significant cancer remains in the Prostate, it may be possible to treat it with one of the Focal treatments or have the Prostate removed. This was my experience and I opted for Focal Therapy, (two sessions of HIFU), as I wanted to avoid what I was told was almost certain to be permanent incontinence if I opted for the surgical route at that point. Eighteen years since original RT in 2008, my PSA is 0.09 and a recent MRI is clear. I was told I would not be given Focal Treatment if the cancer had been outside the Prostate.

If a few spots of cancer are found outside the Prostate, in places not previously treated with original RT, it may be possible to treat these spots with RT of one sort or another.

If there are more than a few cancer spots that develop outside the Prostate, that are beyond treating with salvage RT, it would mean systemic treatment, likely by hormones, chemo or drugs or a combination of these.

Yes, Prostatectomy takes the Prostate out of the equation but in the event that it fails, salvage RT, possibly in conjunction with HT may be needed.

Barry

User

Posted 30 Jun 2026 at 16:25

I have also been offered SABR or surgery. My cancer is localised to the prostrate and is still inside. My Gleason is 3+4 and am a T2c NO MO.

Met with the oncologist and was offered SABR (not MR Linac). Met the surgeon on Friday, he obviously offered removal. He said I didn't need PET or CT scans, no hormone drugs. I just need to decide and then go on the waiting list. He did mention that if I wasn't bothered about not making it past another 10 years, I could also just leave it :) that was in response to my saying I didn't really fancy any of the options.

The surgeon did say though, that if the SABR treatment wasn't successful, prostrate removal afterwards was a very complex op, which he wouldn't do and there are only a few who perform that op.

I am concerned about radiotherapy and the side effects on my bladder and bowel, although SABR is very accurate, but its still the same dose as external beam (I assume).

I asked about incontenence, he said the national average is 10% and his is 5%, but most are dry within 6 months.

Like I said above, I don't fancy any really, am 69 this year, so decision time.

User

Posted 30 Jun 2026 at 18:57

Almost the same conversation as I've had (I'm 67) and same stage as me.

I'm now currently exploring a private route with Retzius Sparing Prostatectomy & NeuroSAFE (look it up) and more importantly picking my surgeon who I know is one of the best in the business. It will cost me but what price do you put on your life.

I just want the best treatment I can with best quality of life that's possible afterwards.

I so know how you feel, hope you can make the right decision for yourself - it's very difficult and mentally exhausting.

Hence I'm spending some of my retirement money now otherwise I won't be here to spend it.

Phil

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