bladder neck invasion. Can it be radiated?

[StephH72]

My husband had radical prostatectomy last week and the pathology report came back with “bladder neck invasion present”, in” right mid and superior posterior and left and right bladder neck”. I’m wondering is it possible to radiate that area after he heals from surgery? He’s a gleason 9/10 and 50 years old with young kids so we want to be aggressive. Or are there other things we should consider to treat the bladder neck? Further surgery an option?

[Tall_Allen]

The risk is permanent incontinence. What is the benefit?

[RMontana]

I had a RP and during this I found I had bladder neck invasion. I also had one EPE (extension) with negative margins. I needed sRT (salvage radiation) immediately as my post RP PSA at 6 weeks was 0.13...that was from my bladder neck where the 'margin' could not be established; they would have had to remove my bladder! So I had radiation. My advise, experience and regret with my treatment deal with incontinence.

My surgeon told me I could advance to radiation when my leakage was below 1 pad per day...this was not good advise. I went into sRT with minor leakage, but full stress incontinence...I came out of sRT with the same leakage. I will have that the rest of my life. I would suggest you look at getting dry before you get radiation. Whatever leaking you have when you go to sRT you will have for the duration (as we used to say). That was my only regret.

Also, its not on the radar now, but think about ED...I did not think about this at all...did not think it would matter or be important. Its important. Your natural spontaneous erections are never coming back. As you progress you lose not only function but size...see my post on when I think men should consider moving on an implant, a IPP...I know, its not that important now; it will be. You will live a long time my friend and it will be important...TNX

Let me know if you cant find the links and I can share...TNX2

[Hidden]

Hi Steph! 50? Omg! I was just 53 but I didn’t have young kids at home . My heart goes out to you and your very young husband . I had pc tumors blocking my urethra and bladder . Yes, they can RT that area . Unfortunately , It is pretty common after and RP when something was missed to need it …For me , it was 8 wks imrt Lupron and another adt that cleared me . I wish the same for him . God bless the family in this storm . My dad got taken down at 71 from this . It is tuff for the kids to see dad weakened . Try to keep his spirits up . Our testosterone being halted is a wild party all of is own making . Love is the best med . He has so many reasons to endure this . God bless you all🙏 Scott

[j-o-h-n]

I only have an opinion, not medical advice. I presently am totally incontinent..... it's really an inconvenience but it beats not pissing at all.

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 02/28/2023 7:12 PM EST