1. < Prostate Cancer

Additional radiation treatment for 2nd recurrence

Posted by firespooks @firespooks, Feb 4 8:08am

My PSA was 5.53 and my Gleason score was 3+4 =7. I had a robotic prostatectomy in 2006. Went undetectable until 2013. I then Had 39 salvage radiation treatments. Went undetectable again . After 2 years my PSA slowly began to rise. I’m now at 1.18. I’m am going for a PSMA scan soon. Can I have radiation again, so I won’t have to go on Lupron or similar ?

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

harvey44 | @harvey44 | Feb 4 10:57am

I am going through a similar situation right now. However, after three PSMAs, the cancer is undetectable at 3.84 PSA. I am currently under no treatment. I have asked the same question to my urologist and my radiation oncologist. My answer was, if the cancer is within the prostate bed, then radiation there again is not possible because of likelihood of damage to other organs. It it is located outside the bed, then it is possible to have radiation administered.

REPLY
1 reply
firespooks | @firespooks | Feb 4 12:19pm
In reply to @harvey44 "I am going through a similar situation right now. However, after three PSMAs, the cancer is..." + (show)
@harvey44

I am going through a similar situation right now. However, after three PSMAs, the cancer is undetectable at 3.84 PSA. I am currently under no treatment. I have asked the same question to my urologist and my radiation oncologist. My answer was, if the cancer is within the prostate bed, then radiation there again is not possible because of likelihood of damage to other organs. It it is located outside the bed, then it is possible to have radiation administered.

Jump to this post

Thank you sir . Good information 👍

REPLY
kujhawk1978 | @kujhawk1978 | Feb 5 5:37am

The short answer, yes...

The PSMA scan may inform your treatment decision, showing where the PCa is this time.

Here's my clinical history, three treatments involving radiation:

SRT to the prostate bed.
Whole PLN radiation.
SBRT to a PLN.

I've had the same radiologist over the years. She says depending on time from last radiation and location, she can treat any lymph nodes again.

As to the ADT, well, there are studies that say SBRT can delay the need...there are studies that say adding short term ADT can increase the progression free survival time, those studies are all over the treatment map, 6, 12, 18, 24 months...there are other studies saying SBRT best used for palliative purposes.

This time around I discussed SBRT to the PLN identified in the Plarify scan. My radiologist thought 12 was the right number. My oncologist originally thought 24 but add an ARI.

After discussions and back and forth, we settled on 12 months as we knew based on my clinical history there was likely micro-metastatic disease.

Discuss with your medical team when you have the results.Also, post those on this forum and members may be in better position to give you their thoughts.

Kevin
REPLY
cesar52 | @cesar52 | Feb 6 7:44pm

I had LN Mets to pelvic region. Got radiation with great results. A year after stopping ADT and Xtandi, a LN showed up in a PSMA PET SCAN. This time in paraortic region. Size:1.6 cm. This time I got just 5 sessions of radiation and started ADT and Xtandi . Again with nice response. PSA came down from 2.8 to 0.06. Except for fatigue and hot flashes, I have tolerated this regimen quite well. My plan is to see if I can continue Xtandi for a longer period of time as monotherapy and get ADT on an intermittent basis.

REPLY
Please sign in or register to post a reply.