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Salvage Radiation

Ab75 profile image
Ab75
19 Replies

What is the best dose? I consulted with two RO's last year, one used 68 or 70 gray the other 72 gray. I am due for a colonoscopy next year, is this safe after radiation?

I planned on taking my family to Universal Studios later this year if pandemic subsides could this cause additional issues from the salvage radiation.

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Ab75 profile image
Ab75
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Tall_Allen profile image
Tall_Allen

(1) Get your colonoscopy done now, before you have SRT. It isn't safe afterwards.

(2) There is some controversy as to optimal dose. My guess is 72 Gy is better based on this:

prostatecancer.news/2016/11...

However, during the pandemic, many ROs are advocating "hypofractionated" salvage radiation. "Hypofractionation" means more intensive radiation finished in fewer treatments. I just looked at your previous post - GS 6 with positive margins- you can probably do just as well with a lower hypofractionated salvage dose: 52.5 Gy in just 20 treatments. It would be completely finished in just 4 weeks.

advancesradonc.org/article/...

redjournal.org/article/S036...

(3) I don't understand what concerns you have about a trip to Universal Studios.

Ab75 profile image
Ab75 in reply to Tall_Allen

Thanks. The trip question would be about getting jarred around riding the rides. If some damaged existed from radiation to the bladder or rectum. On a different topic I was going to wait to .2 psa but I had Dr Epstein take a look at pathology upgraded to a 3+4 including the positive margins. 95 percent 3 with 5 percent 4.

Tall_Allen profile image
Tall_Allen in reply to Ab75

No worries about the rides. That's still pretty much pattern 3, and judging by the PSA increase, it is slow growing.

Ab75 profile image
Ab75 in reply to Tall_Allen

Thanks for the information.

treedown profile image
treedown in reply to Tall_Allen

TA any opinion if colonoscopies become safe after EBRT at some point. I decided against one 6 months after RT and did cologuard instead. I am curious if some point in the future I could get one?

Tall_Allen profile image
Tall_Allen in reply to treedown

I'd wait a year.

treedown profile image
treedown in reply to Tall_Allen

Thank you

in reply to treedown

For what its worth I had a consult with my GI who performed my scope in Dec. 2017. My consult was in Dec 2020. The purpose of the consult for me was to find out if I needed to move up my next scope to 5 years from 10 years.

The answer was no. Im still on the 10 year scope schedule.

treedown profile image
treedown in reply to

I was most interested in timing after RT. I was getting different opinions and my GP said I am good for 3 years after cologuard negative. After missing a screening tool for PC I intend to not miss any that exist fir other ailments if they are available and I should have had a colonoscopy 7 years ago IMCO.

in reply to treedown

No argument from me. I met with my GI to discuss if radiation for prostate cancer increased my risk. He said there wasn't any increase. If you get a different opinion could you share?

treedown profile image
treedown in reply to

I must have misunderstood your reply. I did not think about a correlation between RT and increased risk of colon cancer so thanks for both asking and answering that for me. If I hear otherwise I will let you knownwhat I hear. I am inquiring for screening in general as I have been lax in the past and I intend to change that trend.

in reply to treedown

That colonguard is a good first step. Especially in this covid constrained times. But nothing is as thorough as a scope, especially if there are any pollups.

treedown profile image
treedown in reply to

Agreed.

Ab75 profile image
Ab75 in reply to treedown

From my research if polyps are removed after getting radiation for prostate cancer it puts you at risk for a fistula or improper healing.

treedown profile image
treedown in reply to Ab75

For the rest of our lives?

Ab75 profile image
Ab75 in reply to treedown

If you find the answer to that I would like to know. I had polyps removed last time so thanks to Tall Allen's advice I will be scheduling the colonoscopy before radiation.

Ab75 profile image
Ab75 in reply to treedown

I will ask my GI doctor when I see him.

treedown profile image
treedown in reply to Ab75

I would be interested in his reply.

Ab75 profile image
Ab75 in reply to treedown

I asked my GI today if it would be an issue 2 or 3 years after radiation, he said it should be no problem.

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