Concern about having more radiation to prostate after 43 external beam treatments 15 years ago

[Pickleball38]

15 years ago my husband had 43 radiation treatments after PSA reached 50 & his 3rd biopsy showed 1 core to have cancer., Gleason was 3-3. He has had Lupron injections since then. He was on 250mg of Zytiga with food and 5 mg Prednisone for 3 years until a year ago because PSA was creeping up & he was dealing with anxiety. In the middle of all that he had Covid & osteoporosis. To get him away from the side effects of prednisone, the oncologist put him on Erleadra 240 mg which lowered his PSA but did a number on his mental health so he has been on Lupron only for several months. He just had a Pet scan that showed the cancer hadn’t spread to other parts of his body but there’s a small spot in the back of the prostate that the radiologist feels he can do 5 treatments to that small area. He warned us, of course about damage to bladder especially since he’s had radiation before. He Also mentioned 2nd opinion. We are 3-4 hours from Mayo Clinic in Minn. but we are worried that time frame getting in for 2nd opinion might not be good. Anyone on this forum with experience about getting in for a timely 2nd opinion or procedures other than radiation? Thanks in advance.

[Tall_Allen]

Here's the data:

prostatecancer.news/2016/09...

prostatecancer.news/2016/08...

prostatecancer.news/2017/09...

[Pickleball38 in reply to Tall_Allen]

Thanks Tall Allen. Interesting. If I get the gist of the reports correctly, I maybe feel a little more open minded about salvage radiation.

[Seasid]

Could your husband get Nubeqa instead of radiation?

[maley2711]

I don't see much about hubby's diagnosis on your bio page here? He had RT, PSA dropped to what nadir, and what has PSA history been since then?

Why has he been on lifetime ADT since end of his RT sessions? His PSA continued to rise once he had hit the nadir?

This is a discussion of the topic as found in 2024 AUA guidelines...I think it may be helpful?

auanet.org/guidelines-and-q...

Finds much lower urinary complications with salvage brachy or SBRT!! as alway, need experinced Docs!!!