Rule out future whole pelvis radiation?

[HKKWL]

Just finished hyperbaric Rx (49 sessions) for radiation cystitis(with recurrent gross hematuria). Symptomatically resolved now. Do not know why urologist asked for pelvic US in 2 weeks. Should my PSA eventually reached higher level, 0.14 in Jan 2023, would whole pelvis radiation be contraindicated because of my history of radiation cystitis?

[Tall_Allen]

Is a PSMA PET scan showing cancer in the pelvic LNs only?

[HKKWL in reply to Tall_Allen]

No PSMA PET was done or recommended because of low PSA of only 0.14. Whether there are LNs involved is still an unknown. Because of presurgical(RARP) needle biopsy back in May 2019 was Gleason 3+3, Dr Finelli(urologist) chose not to perform L/N exploration during surgery. Postopt pathology report of prostate subsequently confirmed a Gleason 3+4 with PSM and ECE, resulting in Class T3b.

[Tall_Allen in reply to HKKWL]

So why are you asking about whole pelvis radiation?

[HKKWL in reply to Tall_Allen]

I am just anticipating rising PSA and potential future positive PSMA PET scan, whether my history of radiation complication of hemorrhagic cystitis will preclude the use of whole pelvis radiation, should it be called for.

[HKKWL in reply to Tall_Allen]

EBRT was done in Sep 2020 in view of rising PSA, under Dr Morton, radio-oncologist, as a salvage therapy, over the prostate bed.

[tango65]

If PSA continues going up when it reaches 0.5 or higher request a PSMA PET/CT to see if there are mets in the pelvis or distant mets. If there were pelvic lymph nodes it may be possible to irradiated them with SBRT without including the bladder.

[HKKWL in reply to tango65]

Will need to see what the situation will be like when that time arrives. Agree. Thx everyone.

[Justfor_]

This is what I am doing because, as your case signals, irradiation is not a walk in the park.

healthunlocked.com/prostate...