Shoulder Replacement after Salvage Radiation

[PhxGal21]

My husband just delayed his shoulder replacement surgery after discovering his psa went up after prostate removal. Psma pet scan could not locate any cancer cells, but his psa is now 1.1 after being .87 six weeks post surgery. He knows he will need salvage radiation with ADT. Does anyone have experience with a joint replacement after radiation? If so, what is the proper amount of time to wait to get it done? Our first appointment with oncologist isn’t until the 31st.

[addicted2cycling]

Regretfully I can not address the time frame following radiation for shoulder replacement but as to the SHOULDER REPLACEMENT SURGERY here is my experience --

In 2016 at 66yo (15 months after my GL10 treatment) I had my right shoulder replaced. In August on a Monday morning I had the surgery then saw the PT guy on Tuesday morning at which time he removed the sling and had me move my arm and inspected everything. He then gave me instructions regarding the movement I was allowed and confirmed my Ortho's statement that I was cleared to get back on my bicycle on Wednesday.

My point is that it's been almost 9 years since my replacement and I hope your husband will have an experience similar to mine.

[PhxGal21 in reply to addicted2cycling]

Wow, that’s crazy fast! All my research indicates he would be in a sling for six weeks and be able to lift nothing but a cup of coffee. I’m sure hoping it leans more in your direction. He needs both shoulders done, but this will be the second time he’s had to postpone the shoulder surgery . We falsely assumed the prostate removal would take care of the cancer. He was Gleason 7 at time of removal. Was being watched since 2015.

[addicted2cycling in reply to PhxGal21]

I went to 4 Shoulder Ortho Surgeons and every single one said EXACTLY what your research shows. I happened to see Dr. John Moor (Sarasota, Fl) about my bone on bone knees for replacement and I mentioned my shoulder just as a side bar enquiry. He had some Xray's done then told me he could replace it *NO PROBLEM.* I said NO because of the rehab time frame taking me away from bicycling to which he relied -- "You will back riding 2 days after replacement - GUARENTEED."

Such a DEAL that I couldn't pass up so I had the shoulder done and am still on Bone/Bone knees.

BTW, I am such a klutz I waited until day 3 after surgery to go for a 20 mile bike ride.😂

Good luck to your husband.

[PhxGal21 in reply to addicted2cycling]

Did you have reverse shoulder replacement? I read that you can get out of sling faster with that because they use screws into deltoid muscle instead relying on rotator cup.

My husband already had both knees replaced. I feel like he is going to be the bionic man when he is all done . He is 65. We live in AZ.

Thanks for your feedback. Hope your future knee replacements go as well as your shoulder. I’m sure you will do well since they put you on a machine that matches the peddling on a bicycle for recovery several times a day from day 2.

[addicted2cycling in reply to PhxGal21]

Anatomic Total not reverse. Went back to him after being hit by Wild Hogs while bicycling. First time (April 2020) I suffered 2 cracked ribs, punctured lung, cracked scapula, trauma to LEFT shoulder and was released for bicycling 2 weeks after crash. Second time (July 2022) the hog T-boned me in left leg and fractured the Tibia plus another left shoulder impact. This time I was off the bike for 12 weeks and still have not fully recovered. Being 72 at that time plus the PCa and other stuff has just taken it's toll. Three Saturday's ago I did manage to ride 101 miles but it took 3 individual rides within the 24 hours from my first time mounting the bike unlike the not too distant past when I could ride 100 miles without stopping in under 6 hours.

p.s. - sadly not likely to have the knees replaced.

[PhxGal21 in reply to addicted2cycling]

You are definitely dedicated to your hobby. 100 miles is more than impressive! Kudos to you for getting back to riding after the bad falls and recovery.

[lpol83712]

Not sure the appropriate time is. Had SBRT in September and had followup shoulder replacement (reverse total shoulder) the following August. I wanted to be off any ADT with a testosterone back in normal range as low testosterone causes bone to be reabsorbed so I wanted to be off the ADT. For radiation after surgery with biochemical recurrence it seems to be debated whether ADT is added. If it is added I would avoid shoulder surgery till there was recovery from testosterone suppression if that is possible.

[PhxGal21 in reply to lpol83712]

Thank you for your input. I appreciate your feedback. ADT will be a good question when my husband sees the oncologist on the 31st.

[petabyte in reply to lpol83712]

The bone health issues are due to low estrogen as a result of low testosterone.

Two solutions: use estrogen patches as ADT as per the PATCH trial or use low (replacement) dose estrogen patches with ADT.