Radiation a second time? Recurrent PC

[wat380bjw]

I recently had a PSMA scan done that showed my recurrence is in the prostate and three Iliac nodes ( none enlarged). I had IMRT done 17 years ago, my question is anyone familiar with doing a targeted course of radiation a second time? I will be doing Provenge after the first of the year then researching with an RO if in my case it is possible. I have been on Lupron for years and Darolitamide for three years. My current PSA is 1.19. I have been doing ADT for most of the 17 years. Thank you, guys, for all of your help over the years.

[6357axbz]

When I had IMRT to my prostate in 2019 I was told by my MD Anderson RO prior to the start of 28 sessions that “radiation can only be done once”. I presumed that was because of toxicity issues. Perhaps after 17 years it could be ok, especially as it would be “targeted”. Please let us know what you find out.

[GP24]

The alternatives are salvage surgery with a high risk of side effects or brachytherapy. I would prefer brachytherapy.

[Tall_Allen]

They can certainly give SBRT or brachytherapy to the spots in the prostate, and give you radiation to the entire pelvic LN area (not just the iliac nodes) if that area wasn't irradiated before.

[tango65]

You could discuss doing SBRT to the prostate and the pelvic lymph nodes. Some info:

ncbi.nlm.nih.gov/pmc/articl...

[wat380bjw in reply to tango65]

Thank you for sharing this info. I appreciate it!!!

[tango65 in reply to wat380bjw]

Best of luck!

[Willydad]

I had SR in 2010 after RP, and just this year (22) had SABR done to 3 Mets (iliac and 2 ribs), as part of the research study (SABR-Comet-3). Study purpose is to see if SABR will delay progression.

[wat380bjw]

Thank you!!

[Marshb52]

st got off of it and had gynecomastia surgery for man boobs. Taking testosterone treatments to return to a man. Feeling much better.

[Abcsoup73]

Hello! My father had salvage radiation to the prostate bed in 2003, just one year after his prostatectomy. We were always told he could never have radiation to that area again. Fast forward to spring of 2015...psa was detectable again. Started monthly lupron shots and psa went undetectable until June 2021. In spring 2022, they told us that we could have a consult with RO to see if salvage radiation was again an option. It was! Since it has been so many years since the initial radiation, he was a candidate. He underwent 6 treatments of high dose radiation. Granted, he has had more issues with incontinence, but is happy that he had it done. This was all done at Mayo in Rochester, MN. So yes, there is always a chance you may be a candidate if your initial radiation was many years ago. Be well.

[wat380bjw in reply to Abcsoup73]

Thank you so much

[ron_bucher]

My RO said he has never seen prostate cancer return to any area he radiated. Since I had local radiation in 2008, the second round of radiation I had in 2017 was targeted at lymph nodes outside (above) the local area.