I met with my oncologists yesterday to plan for the next few months. I'm looking for opinions to help make a decision. I'm 55 years old. Gleason 9. Initial PSA 103. About 10 to 12 lesions in lymph nodes, spine, and ribs. I have been on ADT injections for 6 months. I did six rounds of chemo which finished a month ago.
Recent scans show that the lesions and prostate have shrunk although it looks like there is one new lesion in the lower spine. PSA has hovered around 0.3. Doctors think it may have hit its nadir.
I have to decide whether to undergo external beam radiation. There have been two recent studies published that divided patients into two groups: men with more than 4 lesions and men with less. Both studies concluded that radiation does extend life for men with less but makes no difference for men with more. The "more than 4" group was not subdivided. I have to decide whether to undergo radiation given the risk of collateral damage.
I'm healthy, feeling good, and handled the chemo well. I have no pain. I get up 4 or 5 times nightly to pee and I wear a pad when I'm away from home for ocassional leaks. It doesn't bother me too much but radiation may help with that.
I don't have to do radiation right away but the radiation oncologist said it is likely to have a greater impact if it is done while I remain castrate sensitive. Neither the radiation nor medical oncologist has a strong opinion one way or the other. Any thoughts?