PSA 0,7

[Grommi]

my husband had 5 years ago his prostate removed. Now he shows a PSA of 0,7, this has developed over the years, his Gleason is 7. His doctor advised radiation at this point, he had a pet scan done, it showed a rezidiv, but could not be determined if it is malignant. He is 79 years old, we are in Germany, the best clinic for him is Heidelberg, they work with new radiation methods, called Ionic. We are not sure what to do in this situation, according to the doctor, the life expectancy is 4 to 5 years if not treaded, and the cancer can be eliminated if treated. Any thoughts?

[GP24]

The guidelines recommend to radiate the prostate if the PSA value rises after surgery. This shall be until the PSA value is below 0.5 ng/ml, you are already a bit higher, but I would radiate it anyway. In many cases the PSA remains low after the radiation. You can get that done at Heidelberg but I am not sure if the health insurance will pay the cost for this high-end radiation. Usually it is done at a clinic nearby with IMRT radiation. I would recommend six months of hormone therapy after the radiation to make the radiation therapy more effective.

[Grommi in reply to GP24]

thank you for your reply, we will need to talk to the Oncologist and decide. TRICARE for life will pay for most of it. Heidelberg Clinic is known for excellent cancer treatment, it is an hour from our home. We just hope that we will not have to drive 5 times a week for six weeks. We also are not sure how strong this HIT radiation is, if possible, I have to drive my husband

[GP24 in reply to Grommi]

The usual IMRT radiation will be 5 times a week for six weeks, The HIT will need less than that, depending on the radiation plan 5 or 10 sessions total. If you want to get that done, you have to talk to the radiation oncologists at Heidelberg to discuss this. Your Oncologist can only refer you to them, he will not know details about the HIT therapy.

klinikum.uni-heidelberg.de/...

[Grommi]

thank you, we set an appointment immediately, my husband’s Urologist has set up a referral already

[Justfor_]

Don't know the specifics behind the marketing term "HIT", but my best guess is that is nothing more than what has been known as carbon-ion particle RT. Pioneered by the Japanese ~10 years ago has been offered in Europe (Austria and Italy) before Heidelberg. The theory behind is that accelerated carbon nuclei, because of their higher energy levels, can kill cells that proton and photon can't. Bottom line, I would certainly go with it.

[Grommi in reply to Justfor_]

thank you for the info

[Tall_Allen]

Heidelberg has carbon ion external beam radiation, which looks very good so far.

prostatecancer.news/2016/08...

If he has residual cancer, it can metastasize eventually. Why not cure him?

[Grommi in reply to Tall_Allen]

thank you, we will use this method if it is possible

[RJAMSG in reply to Tall_Allen]

Good morning Tall_Allen, your question, why not cure him (?) regarding that Carbon treatment, was that a why not go for that treatment that might likely cure or was it referring to a different treatment path? Just curious.

[Tall_Allen in reply to RJAMSG]

The OP asked "the life expectancy is 4 to 5 years if not treaded, and the cancer can be eliminated if treated. Any thoughts?"

[RJAMSG in reply to Tall_Allen]

Gotcha, for his age not sure if Hormones are appropriate may not be worth the associated cardiac risks, 50/50 call but at that low of a PSA why not treat with standard salvage radiation to prostate bed (better at <0.2 than 0.7). Thanks

[Tall_Allen in reply to RJAMSG]

Cardiac risk is small, not 50/50.Hormone therapy significantly approves outcomes at his PSA. OP has access to carbon ion.

[Hidden]

I'm a prostate survivor myself with IMRT radiation. I've heard of situations like this before and I wonder if someone can help me understand something. If the prostate was removed, where is the PSA coming from? Did they not get all of it during surgery? I know they radiated my seminal vesicles along with the prostate but I don't believe they make PSA.