Salvage radiation therapy after radical prostatectomy

I had 39 salvage radiation treatments 7 years after my prostatectomy, in 2013. My PSA had gone up to 0.22. Since then I’ve had ED, increased urinary urgency, leakage and increased bowel movements.

Cancer came back 16 months after removal. 35 treatments. Way too many problems afterwards. Gross hematuria radiation cystitis radiation proctitis total incontinence catheter for almost 3 years. Many hospital stays. Failed aus placement and finally removal. Urethroplasty . 3.5 years of uti and miserablelife..Suprapubic catheter for another year and finally found great surgeon who installed another aus and much better now.

I forgot. Add 50 HBO treatments. Good luck.

Sorry you have to go through salvage radiation, but it is likely necessary. Based on my experience (salvage radiation beginning 11 months after RP due to a PSA of 0.5), you may anticipate side effects to your bowel, bladder and sexual function. In my case, Imodium and high fiber helped with my bowels. Although I was told bowel problems would cease about a month after radiation they persisted for about 10 months. Increased urination especially at night which I attributed to ADT, resolved itself once the ADT left my system. Leakage still persists but is not a significant issue except in the bedroom. More on that later. Assuming you’ll be on some form of ADT, expect a low or nonexistent libido. That should improve a few months after the ADT ends. Urinary leakage during sexual arousal remains a problem for me. I have started using a condom for intercourse, and that helps insure I will not dribble in my partner. For me, the side effects of salvage radiation were much worse than advertised. However, given that I have been cancer free for more than a year now, salvage radiation was definitely worthwhile.

2 years of lupron. Been done for 3 years. Bad side effects. Still have bad hot flashes. 3 different meds and none work. Muscle loss and weight gain. But 5 years since radiation and still here and psa undectable. Good luck . HBO also caused problems. Have a great day

Have they done a PSMA PET scan yet to determine where exactly the recurrence is? What (& where) were the SUVmax scores from the scan?

I had Salvage Treatment: 37 IMRT radiation txs over 8 weeks to whole pelvic floor and pelvic lymph nodes together with a 4 mos short term of ADT.

See SPPORT trial info.

This was shortly after my Prostatectomy. My PSA was "persistent"; 1st 90 day PSA .19 (did not return undetectable).

Referred immediately to Radiation Oncologist.

Bowel/bladder: 1st 4 wks no particular issues. 2d 4 weeks, increasing diarrhea and some pain/ stinging upon defacation. Resolved 2 - 3 wks after radiation completed.

Same experience for a salvage treatment friend.

Sexual function: I am not a good resource to respond; the ADT eliminated any libido and I was only a few months out from surgery and erectile function return was in its infancy.

On the happier side, my uPSA 1 year post salvage treatment has been undetectable at < .02 (limit of testing accuracy at Quest Labs).

Also, started ADT a month prior to radiation and that "no fun ride" made I difficult to distinguish between SEs from ADT and/or radiation.

Best wishes for a successful treatment.

PSMA Pet scan didn't reveal distant spread. Thank you...

What is uPSA? What is SE?

there are regular PSA tests which generally measure PSA to .1 and anything less is reported as < .1

And < .1 is the goal post surgery

And there are ultrasensitive PSA tests (uPSA) which have lower levels of detection: Quest Labs limit of accurate sensitivity is < .02

Johns Hopkins is, or was, < .03

I have seen reports into the 3 digits, such as < .008

Honestly, not sure why there are different tests to such low levels. 🤔

I infer that allows a patient to follow any rise in PSA post treatment, even at extremely low levels.

If my PSA rose for example to .04 from < .02, I would "lose my mind", but I do not think that it would trigger any treatment; certainly would trigger closer monitoring.

One friend post surgery and post salvage treatment is being tested to < .1 level.

I believe that some MDs feel it reduces anxiety w/o impacting negatively on care and treatment to test to < .1

SE is shorthand for Side Effects (sorry)