Recurrence: How effective is RT after surgery?

[Lewis22]

This is my first post on this website. Following surgery in 2020, I had a recurrence in 2021. I started bicalutamide on August 21 and completed salvage RT in January 2022. It would be helpful to hear from others who have been through a similar experience and it would be beneficial if anyone could comment on the effectiveness of salvage RT. I am fully aware that many factors affect the "curative" effect of RT after surgery but any knowledge or experience would be appreciated.

[Burk]

Did your PSMA show any distant mets? I was GL7 N0M0 PSA 33. I received RT in 01/21 + 24 mo ADT. My latest PSA was <.10. I am thrilled with outcome. Potentially curative! I wish you the same!

[Lewis22 in reply to Burk]

Hi! Thanks for the reply. No distants mets found on PSMA scan.

[tango65]

It depends on what type of radiation therapy was done and if ADT was use. This is a ;link to a RCT which could give you and idea of the results according to type of radiation and use of ADT

pubmed.ncbi.nlm.nih.gov/355...

[Lewis22 in reply to tango65]

I had 33 sessions of IMRT. Completed January 2022. Bicalutamide started in August 2021. Thanks for the link.

[London441]

Need more info. Gleason, stage, PSA post op any ADT with the radiation etc.

[Vangogh1961]

I am oligometastatic, but had radiation to the pelvis as part of the EXTEND trial. The rad onc was very serious when she said, if it comes back, it won't be from the pelvic area.

[Lewis22 in reply to Vangogh1961]

That sounds extremely positive which I have to say is a rare occurrence in the PCa world!

[Vangogh1961 in reply to Lewis22]

I had bone mets, so I'm under no illusions it will not return, but zapping the pelvis to reduce the chance was my goal.

[Lewis22 in reply to Vangogh1961]

I know RT and salvage RT can be curative BUT what factors need to be present to ensure this outcome? Unfortunately, to date, research evidence is inconclusive in this respect. However, similar to your view, I am hopeful that surgery followed by RT and HT improve my chances of survival.

[farmanerd in reply to Lewis22]

It's fruitless to look for certainty when highest probability is all you'll have for making decisions.

[Lewis22 in reply to farmanerd]

I am not looking for certainty. I understand that everyone’s cancer experience is different. I just wanted to know if anyone involved in this website had a positive experience with salvage RT and if so, how similar might they be to me e.g. age, cancer staging, hormonal therapy etc. I have “existed” with a cancer diagnosis since 2014 and fully aware of the lack of certainty in prognosis. I have had negative experiences on some so called online support groups and I hope this is not going to another one! If the highest probability is all there is, then ok, let’s just get on and deal with it. Obviously, PSA testing after primary treatment removes any probability anyway!

[Helenhu26 in reply to Vangogh1961]

Did you get to radiate all sites after two months ADT? How many bone bets do you have? John has one bone met on the right rib and one on the left illiac

[Lewis22]

Gleason 7, T3a, Post op PSA 0.03, Margin status: extraprostatic extension for 1mm and 1mm but specimen confined circumferentially - recurrence PSA rose to 0.53, 150 mg bicalutamide with 33 sessions of IMRT (whole pelvic salvage radiation)

PSA 26 May 2022 <0.01

[keepinon]

I had an immediate recurrence after surgery. Went on Lupron and Zytiga followed by SRT 8 months later. After 2 years of L&Z and a year off everything I am still undetectable. Next PSA test on Monday. Still holding my breath every time! I should mention my "T" has not recovered and is still very low.

[Arrayscout]

I had surgery in 2011 and SRT plus ADT (18 months) in 2012. PSA undetectable today 10 years later.

[Lewis22 in reply to Arrayscout]

Excellent! Thanks for your informed and positive response.

[maggiedrum]

I thought the extensive guide that "male2711" posted had some thoughts on RT. I am only going by my vague memory but it might be useful to you. He just posted it this week.

[Lewis22 in reply to maggiedrum]

Thanks! Will have a look….

[Channelhomec]

Had surgery 2013 gleason 3/4 confined to capsule one positive margin less then 3cm 0.06 to 0.08 for 6 yers then recurance 0.14 SALVAGE RADIATION ,GOING ON 3 YEARS HIT O.1 ONCE 04/ 22 >LAST PSA <0.05 8/42022> HAVE A ONCOLOGIST FROM SLOAN NOW, THE RADIOLOGIST SAID IT WAS CURABLE he was CLUELESS >MY UROLIGEST SAID I was cured CLUELESS...never told me of positive margin found out latter...just waiting now I don't belive I am curable.... surgery went well