I was finally able to get a long awaited PSMA scan. The radiopharmaceutical used was F-18 labeled rhPSMA-7.3. There was no evidence of residual/recurrent tumor, although over the last 5 years my PSA has gone from .04 to .41.
It seems my best option now is to simply start salvage radiation. Given the slow rise in my PSA value, the radiation oncologist is considering the possibility of not including ADT at the same time. I’ve explained how badly I reacted to ADT 4 years ago when I received a single Firmagon shot, which is why this is a consideration.
I’ve been researching to try and find out exactly what to expect during my first simulation or preparation, and the following 45 days of radiation. Should I expect to be able to continue with normal daily activities? Should I prepare for a period of being too exhausted to do too much of anything? Just curious if someone can explain what I should expect.
Thanks!
This explains what you can expect from primary radiation:
prostatecancer.news/2018/10...
That is written with primary radiation in mind. With salvage radiation, urinary side effects may also include incontinence. Sexual side effects are sometimes more with salvage - good idea to take daily Cialis or Viagra from the start. Because you are LN+, they will treat your entire pelvic area. Side effects of pelvic radiation may be lower if you are a "bear." The extra fat protects the bowels.
For most guys, side effects are not severe enough to interfere with work of other activities. Fatigueincreases with the number of treatments - it may occur towards the end. To prevent it, exercise a lot! This is not the time to take it easy. I doubled my cardiovascular workouts and had no fatigue whatever. It also helps radiation work better:
prostatecancer.news/2017/12...
Because of the pandemic, and to prevent fatigue, it is a good idea, especially now to talk to your RO about a shortened course of radiation, cutting your treatment time in half:
prostatecancer.news/2016/08...
You were lymph node positive, so I'm afraid you do need some kind of ADT - 2-3 years of it. Send your RO this link and discuss with her:
europeanurology.com/article...
Thanks, Allen. One question- are you familiar with peripheral hormone blockade therapy? My medical oncologist has mentioned this as a replacement for full ADT, but only after 6 or more months of ADT, and after SR has been completed. My understanding is that peripheral hormone blockade therapy does not deplete testosterone, yet it prevents it from feeding the prostate cancer cells.
I think you're talking about bicalutamide. It's not as good, but if that's the most you can tolerate, it's better than nothing.
Thank you again for the support documents. I am facing SRT in 2 months after starting Firmagin this week. I was trying to lose weight (5'10" and 195) due to anticipated ADT weight gain...now 2nd thoughts given your bear comment. So much info...so many decisions