Salvage radiation therapy after radical prostatectomy

The short answer...the fatigue is likely the Orgovx and Zytiga, the nausea more likely the radiation.

Well, as others have said, those who have not experienced side effects from SRT, may not post on this or other forums.

I did SRT after a very successful surgery in March 2014, PSA was undetectable using standard PSA to a single decimal point until 15 months out (roughly September 2015) when it came back as .2, then 90 days later, was .3.

At the time, data was emerging from clinical trials as well as Mayo that in high risk PCA with BCR, there was often spread outside of the prostate bed to the PLNs and recommended treatment was SRT to the prostate bed, extend to the WPLN and include short term (six months) ADT.

I brought this data to my medical team who dismissed it saying there was no long term data to support it and the SOC was SRT to the prostate bed only.

Ninety days after completing the 39 IMRT, 70.2 GYa to the prostate bed only, epic failure.

So, understand your decision as it is from your radiologist, it is the "SOC" though as I have said before on this forum, are population based and historical, question, do you have an oncologist on your medical team, if so, what did that individual say, if not, consider consulting one.

The NCCN Guidelines, #13 for PSA persistence or recurrence after surgery suggest that if no other signs of cancer, radiation with or without hormone therapy or monitoring (see, choices, no definitive answer...!). So, your PSMA tests says "no cancer sign of cancer...yet, we intuitively know there is, otherwise your PSA would not be rising. At that PSA, low probability, rough 1/3, of finding any recurrence. There may be other data to aid in your decision making, the pathology report from your surgery which would indicate GS, GG, PSA tests which would give your PSADT and PSAV...

Question is, how aggressive do you want to be? In part, that depends on how aggressive your PCa is. The fact that it has returned may answer that question. As I said, so will your pathology report and PSA tests over time.

But, to answer your question since I haven't yet. I did not experience any SEs from my SRT. Why, who knows. I'm going to go with a highly skilled radiologist and her team.

Kevin

I had a Prostatectomy in 2006 then had 39 radiation treatments in 2013 for recurrent cancer. I now have urinary frequency, bowel movement frequency and ED. I’m now on my 2 nd recurrence and both of my doctors are just watching and waiting on my PSA levels.

Hope you are coping with your symptoms. May I know your Gleason score and PSA-DT and age? Wish you best my friend...

My Gleason score is 3+4 =7 . My PSA before Prostatectomy was 5.53. Before salvage radiation was 0.22. Now PSA is 1.16. I am 73 years old.

I had a Prostatectomy in 2006 then had 39 radiation treatments in 2013 for recurrent cancer. I now have urinary frequency, bowel movement frequency and ED. I’m now on my 2 nd recurrence and both of my doctors are just watching and waiting on my PSA levels.