SRT Treatment for Prostate Cancer

[Ab75]

I had a prostatectomy 3 years ago since then psa has climb to .09. I was thinking of putting off SRT until reaching .2 I am concerned about the potential side effects of radiation. My pathology was G6 pt2c with positive margins at right apex and right lateral. Decipher score was .38 low risk. Any thoughts?

[Tall_Allen]

GS6 presents a challenge for SRT - even if some GS6 was left behind, will it ever progress? Here are some of the issues:

pcnrv.blogspot.com/2017/11/...

[tango65]

Gleason 6 may not progress in many patients, but prostate cancer is not an uniform cancer and it could be areas where the cancer had a higher Gleason score.

I believe that there are different opinions about when to start salvage radiotherapy. PSA less than 0.2 based mainly in retrospective studies using equipments, techniques and doses different than the ones being used in contemporary treatments. Others may argue to wait until the PSA is 0.4 since in some patients the PSA stabilizes at that level.

I will get treated since there is a chance of curing the cancer . I had radiation to the whole pelvis in 2005, two years after the prostatectomy. The treatment and its undesirable side effects were easy to tolerate. Some fatigue, some intestinal pain and rectal pain. Everything went away in a couple of months.

[Biteson62]

Get a PSMA-PET scan ASAP. This will help visualize everywhere in your body the cancer resides. If still in the prostate bed then SRT is appropriate and the side effects minimal if a rectal gel spacer is used.

[GP24]

Allen wrote: "even if some GS6 was left behind, will it ever progress?"

It should not progress. If you have a Gleason 6 you could choose active surveillance or watchful waiting instead of surgery or radiation. Now the prostate is removed and only a tiny lesion of Gleason 6 remains. No need to worry about that. Just watch it for the next ten years and longer.

Your PSA value of .09 is far too low for a PSMA PET/CT.

[Hidden in reply to GP24]

👍. Sound advice ..

[Hidden]

I think that you’re in good shape ...if you’re at .09 I’d say thats fantastic for now...please ...don’t rush into thinking you’re castrate resistant .... live well ..😎

[Ab75]

Thanks for the information.

[Howard53545]

I had surgery PSA climbed to .13 had radiation PSA went to .08 then .13. Now at .16. Next test is Aug 22. Too low for Axium scan.

[Howard53545 in reply to Howard53545]

Now it’s .55