Salvage radiation

[Channelhomec]

Information on this subject

[Magnus1964]

It is called "salvage" radiation because it targets one spot. I have had salvage radiation on my hip several years ago. The lesion had stayed dormant since.

[Channelhomec in reply to Magnus1964]

Thank you hopefully it will work for me my doctor waited till it reached 0.1 before talking about it it took 6 years

[rscic in reply to Channelhomec]

Waiting to 0.1 is typical unless Adjuvant RT is offered which is typically with EPE (Extra-Prostatic Extension) and/or Positive Surgical Margins. Adjuvant RT is a bit controversial at this point as there is a well done 5 year study which says those who received Adjuvant RT did just as well as those who waited & later received Salvage RT. The controversy is over whether a well done 5 year study is long enough or is 10 years (or some other number) more definitive?? As far as I know Adjuvant RT is still paid for by insurance .... mine was paid for in 2018.

BTW Salvage RT is RT performed AFTER PSA has risen to at least 0.1 or 0.2. Whereas, Adjuvant RT is RT performed BEFORE PSA has risen to 0.1 or 0.2 but there are indications the cancer has left the Prostate (EPE and/or Positive Surgical Margins) but there is no specific tumor site seen.

My understanding is, Salvage RT can be focal to a specific metastasis or to an area (such as the Pelvic soft tissues). Often with BCR (Bio-Chemical Reoccurrence) only the PSA is an indication of Prostate Cancer Reoccurrence and Salvage RT given in this case can be to the pelvic region as well as possibly the peri-iliac regions. Additional treatment such as ADT is often given with Salvage RT but ADT is somewhat controversial with Adjuvant RT.

This is what I understand of Salvage vs Adjuvant RT.

Good Luck,

Rick

[Channelhomec in reply to rscic]

Thank you for the information

[Tall_Allen]

Please explain. Your profile said you had salvage radiation in 2019. What is it you want to know?

[Channelhomec in reply to Tall_Allen]

Is there a time frame on when psa hits its lowest point I read that psa half life is 3 months and up to six with salvage radiation ,is a positive margin the same as cancer leaving the Prostate , my pathology report said cancer was contained . I am a little aggravated that my urologist waited till I reached o.14 after surgery. My psa was at 0.06 and fluctuating for six years (thanks for the input) happy I found this forumI DONATE TO ZERO PROSTRATE

[Tall_Allen in reply to Channelhomec]

It can take years for PSA to reach nadir after radiation. However, the PSA from the tumor is often suppressed by adjuvant ADT.

PSA serum half-life is 2-3 days, but that is a different thing.

[Channelhomec in reply to Tall_Allen]

Was not on any ADT said I did not need it for Gleason 3/4 thank you for the response much appreciated

[fluffyfur]

Waiting until your PSA rises to .1 is pretty standard before starting salvage radiation. My husband's RO waited until his rose to .2

[Channelhomec in reply to fluffyfur]

Thanks for the information we read so many different opinions on line it gets confusing hope he is doing ok

[fluffyfur in reply to Channelhomec]

He finished salvage radiation in August. He seems to be feeling ok, just some lingering fatigue. His stats were like you. G3+4 and a positive margin. However his PSA rose about a year after surgery. His doctors advised that he should not start radiation until he had three consecutive rises in PSA.

There was a study published fairly recently I believe that concluded that waiting to do radiation (salvage) had equally good outcomes as to those who chose immediate radiation after surgery (adjuvant).

Here is one of them thelancet.com/journals/lanc...

[Channelhomec in reply to fluffyfur]

Sounds like he is on the right path it took six years for mine to reach 0.1 all we can do his hope and pray

[MateoBeach]

The “positive margin” on path report means the cancer extends all the way to the edge of the removed prostrate. Therefore suggesting a higher probability that cancer is also remaining in the prostate bed. So if BCR PSA then salvage RT would give full treatment to the prostate bed and ideally also to the pelvic lymph nodes up to the aortic bifurcation. This presumes you do not have any evidence of distant metastasis on scans. In which case this will give you the best last chance for an actual cure. Most believe some adjuvant ADT for some period may improve chances for success with such SRT. Best of luck to you

[Channelhomec in reply to MateoBeach]

Thank you

[GeorgeGlass in reply to MateoBeach]

What is the average benefit, slowing the psa for ahile, extending the life of the ADT effectiveness, overall longevity/lifespan for PCx specific mortality?