Second Chance of SRT?

[KSK54]

Prostatectomy in 2010. PT3ANOMO. Salvage radiation to prostate bed only with nine months of ADT in March 2017. After remaining undetected for one year present PSA is 0.075, increasing last three monthly tests.

If it keeps increasing can I take another chance and get SRT this time to the whole pelvic area/lymph nodes etc?

Very good health otherwise, had very little problems from earlier SRT and ADT.

Just a thinking for a possible cure, otherwise ADT route for rest of life.

Any good RO recommendations for this job ?

Please guide.

Regards.

[Tall_Allen]

It's certainly a possibility worth discussing. Did your last CT show any enlarged nodes? Where do you live?

[KSK54 in reply to Tall_Allen]

Hi Allen,

I am from India. Before starting SRT I had 68GL psma Ct which is available here and it showed all clear.

Yes, during robotic prostatectomy some suspicious lymph nodes from right side were taken out and they were fine. But I did have extra prostatic extension and perinurel invasion.

I plan to let the PSA go up a little more, say 0.5or 1 then get another 68 gl and then decide accordingly.

[KSK54 in reply to KSK54]

I had biopsy in John Hopkins and prostatectomy in Orlando from Dr Vipul Patel.

[KSK54 in reply to KSK54]

PSA at dx was 8 and before SRT it was .23

[Tall_Allen in reply to KSK54]

Sounds like a good plan. You've investigated the pelvic LNs already and they appear not to be involved. It is likely that your PC is systemic, and that only systemic therapy can help, but there is little to lose by taking another look.

[KSK54 in reply to Tall_Allen]

Thanks Allen.

Yes it seems to be systemic now. Nothing much to worry. It is low grade,slow and lots of new things are in the pipeline. I will fight it out.

Allen you are a great asset to this as well as other forums and to all fellow pc warriors.I have been following you since years.

Your knowledge is immense and up to date. You answer all and always give science/research based up to date advice. Great service.

God bless you.

[dress2544 in reply to KSK54]

I totally agree with you. Tall Allen is really an asset to this community. His opinions and suggestions are always based on research. I didn't have anything to say more than what Tall Allen said about your treatment options.

[tetech]

We heard at the cdmrp. Mil from a patient who had a second salvage radiation treatment this time with protons and it was successful they pretty much radiated the same prostate bed that he had had the radiation on earlier. protons we're possible to use where the regular radiation couldn't be used twice.

[KSK54 in reply to tetech]

Thanks tetech. I will look at this option too.

[cigafred]

I had SRT to the prostate bed that did little, and also IMRT to common iliac and para-aortic nodes. Currently on first-line ADT, RO suggested the possibility of taking an ADT holiday, waiting for a PSA rise, doing an axumin scan, and then radiating whatever shows up. Something to ponder, at least for me.