salvage radiotherapy

[Tommyj2]

does anyone know how long one should wait before discontinuing meds after salvage SBRT to see if it was effective? It’s been around 2 months and my next meeting with my MO is Jan 3. I’m supposed to get a 3 mo eligard injection at this time…..should I forego this injection?…..RO is not my primary doc and he says 2 months……it will be months before I will know anyway but I do want to give the radiation time to work it’s “magic”……

[Tall_Allen]

I can't tell from your profile where you had salvage radiation - was it to your pelvic lymph node area? Were cancerous lymph nodes detected? If you stop your ADT too soon, you will cause the resistant cancer to take over.

[Still_in_shock in reply to Tall_Allen]

What's too soon? Before the 2 year/ 3 year protocol?

[Tommyj2 in reply to Tall_Allen]

Psma and mri revealed remaining cancer in the prostate itself….proton SBRT done by mskcc doc in November….thought it was 2 months since it ended but 2 months since I started…..No lymph node involvement. Plan was developed to be potentially curative……don’t want to do anything to mess things up…..currently on eligard Zytiga and pred with psa undetectable……. Conversation to be had with MO but wondering how others have proceeded in similar circumstances.

[Tall_Allen in reply to Tommyj2]

You should have had 2 years of ADT with your original EBRT because you were high risk.

[vintage42]

So in 2012 you had prostate EBRT and no ADT. Now you have cancer remaining in the prostate for which you had salvage SBRT and are starting ADT with a shot of Eligard.

I am similar because in 2021 I had prostate EBRT and no ADT. And a year ago scans showed cancer remaining and growing in the prostate, for which I started ADT. However, I am told I cannot have salvage radiation like you. Apparently it is too soon for me to.

We both made a mistake in not starting ADT right after our initial EBRT. You should take the Eligard now, and then continue on ADT therapy. The salvage prostate radiation alone should depress the PSA, but without ADT, it will surely rise again as there are cancer cells throughout your body.

[Tommyj2 in reply to vintage42]

Thank you for the response….. I need to clear one thing up….ive been on ADT upwards of 13 months now …..1 yr on prior to SBRT…… according to my doc at mskcc it’s not at all uncommon for people who did everything right to have residual cancer……they were somewhat hopeful for me as 12 yrs out I am still showing no signs of metastatic cancer…..everything detectable has been confined to the prostate……intention of the SBRT was curative……odds run around 60 %…….prepare for the worst…hope for the best…. Just hope that a couple more yrs down the road they come up with something better for CRPC…..

Again….thanks for the response and best of luck to you.