Salvage radiation worries

You don't say where you live, but you are thinking about being treated in Rochester or NYC? Nice to have flexibility of location for a treatment that can take 5+ weeks (every weekday) - plus makeup days for those missed due to bad weather or illness.

13 years ago, I didn't have that flexibility. My main concern was choosing a radiologist from the local options. At that time, I read how important it was to go to an "artist". If that doesn't induce anxiety, I don't know what does.

I doubt that is a concern these days, with better imaging tools.

I went with the recommendation of my urologist. All of the men with PCa I met in the waiting room were with another radiologist. The wisdom of the crowd? No, they wanted a man. I stayed with the (female) "artist". LOL

The other radiologist certainly had more PCa cases than my doctor. Did that automatically make him the better choice? I haven't lost sleep thinking about it.

The advantage of local treatment (within an hour's drive or so)? In my case, the ability to have a nap when I got home. It can be tiring. And being close to a toilet. Radiation proctitis set in during the second week. Might not happen to you, but I was glad to be treated near home.

Best, -Patrick

Both excellent facilities, at the top of the heap, or near the top of the heap for cancer care. While salvage therapy has sort of a bad sound to it, not the case. Easy for you to get through it, and you should move quickly. It is to our benefit the PSA has been watched closely, and caught at this stage. You need to move before you get higher-don't want it to reach .5 or results from the salvage therapy drop significantly to around a 35% cure rate, where now you are at 95%. This stats are readily available, talk with your team, and move forward. Good luck. Remember as well not all facilities have radiation oncology, and although a brief daily treatment it is consecutive days, and you should consider convenient locations for your travel to and from the treatment-don't know where you're located, but snow/weater may play a part.

Good Morning Blount,

All things being equal, it may be worth a look at proton beam radiation in addition to traditional IMRT. The expense is higher, but if you have Medicare and it is approved, the out of pocket will be $0.

My current Med Onc recommends the University of Pennsylvania (Philadelphia) and I have had many friends go to Jacksonville to the University of Florida facility and rave about the level of professionalism and quality of care. Both of these locations are proton centers.

Best wishes. Never Give In.

Mark, Atlanta

W/ all the new scans that can show where the PCa is, I personally would not have SRT w/o one. Lots of blind SRT failures because that's not where the cancer was.

I am heading down the same route. Working with Sloan Kettering in ny/nj

Last PSA was 0.27. Unfortunately/fortunately my pelvic and full body 3T MRI were clean (they were taken at PSA 0.21). As others mentioned it is a bit of shot in the dark.

But I used the calculator and get 68% chance for 6 yr remission.

mskcc.org/nomograms/prostat...

So taking the risk. I am also doing 6 month ADT

What I saw was the more success has cut offs at 0.2 and below. Next is 0.2-0.5. Then it drops off

ADT added to success factor and I have a fast doubling rate. So chose it to try to freeze progression prior to radiation.

Best of luck to you.

And good luck to you as well Email 1. I may very well end up at Sloan Kettering.

Knowing of your journey is helpful to me as I evaluate options.

Blount

Had RRP. PSA undetectable for 17 months and moved to 0.3. Also concerned it would go past 0.5 so pulled the trigger. 3TMRI negative. 39 IMRT treatments ending in Mar. 2016 with total of 70.2 grays to pelvic bed and lymph nodes. 3 months monthly Lupron before and 3 months during treatments. 9 months post IMRT with undetectable PSA and no side effects from radiation. Another PSA next week. Wishing you good outcomes.