Radiation Questions

[ar2567]

Post RARP, and I'm meeting with my surgeon's PA to discuss next phase of treatment. Margins, nerves and seminal vesicle were positive, so probably continuing with ADT with addition of radiation. Question: What questions should I be asking on Friday? Any additional guidance is appreciated. Thanks!

[Magnus1964]

Most radiation treatments begin with a few months of ADT. Ask which drug he/she intends to use. Lupron is a good starter and can be continued after radiation.

[ar2567 in reply to Magnus1964]

Thanks, currently on Orgovyx (oral ADT).

[Tall_Allen]

• Here are some questions to ask:

prostatecancer.news/2017/12...

• Whether or not you have RT now (called "adjuvant") or whether you can comfortably wait for a PSA rise (called "early salvage") depends on your PSA:

prostatecancer.news/2019/09...

• However, in some cases adjuvant RT has better results:

prostatecancer.news/2021/10...

• Whether you have "adjuvant ADT" with it, depends on whether your PSA is over 0.6:

redjournal.org/article/S036...

• Whether or not your pelvic LN area is treated at the same time, also depends on PSA:

prostatecancer.news/2018/10...

• If your PSA>0.5 or is rapidly rising, get a PSMA PET scan to rule out distant metastases. Also, discuss a Decipher score, which may lean you toward more intensive treatment if high and less intensive treatment if low. Consider enrolling in this clinical trial:

clinicaltrials.gov/ct2/show...

[ar2567 in reply to Tall_Allen]

Thanks so much!