Anyone had salvage radiation therapy post-prostatectomy?

Salvage radiation It’s pretty common for what to do in your situation. Need to wait 4 to 8 weeks after surgery, depends on the doctor. They get the whole prostate bed so you don’t need to be concerned with whether they got all of the margins.

SBRT radiation to the margins can also be done. They don’t do this for higher risk cancer patients.

A PSA test is sort of irrelevant at this point. Once they do the radiation, a PSA test would make more sense. Because you just had surgery, your PSA has probably dropped a lot.

I didn’t get salvage radiation until 3.5 years after my surgery. I went for about seven weeks, but never had any side effects as a result. About five years after radiation I started having some incontinence issues, not bad however.

@mmmvegas There are different types of radiation machines that have more or less side effects. The Mridian and the Elekta Unity have a built in MRI (vs fused images) so what they see in real time is treated in real time. The side effects are MUCH less as determined by both my personal experience of 5 hypo fractional treatments and the mirage randomized trial.
https://www.urologytimes.com/view/mirage-trial-margin-reduction-with-mri-guided-sbrt-reduces-toxicity-vs-ct-guided-sbrt

Your surgery lasted a long time . I had Operation in 2021 . My PSA rose to 0.14 , that was 1.5 years ago . Decided to get Salvage radiation then . Since then PSA has been very low in the 0.03- 0.045 range . No side effects really . A little 'jumpy bladder ' for 3-5 months but fine now . I did radiation early . 22 sessions , no ADT or anything else. Seems to work well . Keep us informed and best of luck ! James on Vancouver Island .

@bens1 I've read that the MRIdian from ViewRay has been removed from use at all locations as the company went belly-up. It sounds very promising as does the Elekta Unity.
Which machine provided your treatment? I assume you live near UCLA where the trial is currently in practice. Was this for prostate surgical margins only or did it include pelvic lymph nodes?

@krs03 Where did you read that as the company that bought them, or the rights, is receiving $1 million dollars per year to support each machine. That company hired the original people from Viewray. There are a number of the machines being supported in Florida where I am . I spoke with someone on this web site yesterday that is about to be treated on the Mridian and he is in Pennsylvania. Cornell Weill in New York City still has it and others do across the US.

I was treated with the Mridian in the Orlando area and I had the chance to be treated with either the Mridian or Proton. I know it is being used for Oligometastatic cancer spread and for other types of cancer but not sure about the pelvis specifically.

The important piece is the bult in MRI, whether its the Mridian or the Elekta Unity, as that means the margins are much smaller reducing exposure and SIGNIFICANTLY reducing side effects and toxicity.

@vancouverislandhiker- Thank for the feedback. This is exactly the type of information I am looking for. I appreciate all on this forum and the valuable experiences you share.

MMM , just my thought process here . IF it looks like your PSA is rising and it could be the start of a reversal , hit it hard and early with Salvage Radiation. At 0.13- 0.2 , normally its the ideal early stage to go after that rising PSA and bad cells in Pelvic region. MRI showed nothing and PSMA- PET scan would most likely show nothing at this low level , but you can be proactive . If yoru going to get Salvage at some stage go " pedal to the metal" is my thinking . your values are very low at 0.13 or so , so you maybe could get away with 20 or 22 (like me ) and no ADT . Im not a doctor , more of a decent Airline Pilot , but my father and grandfather had prostate cancer and my father died of prostate cancer at the age of 67. I have always got my physicals of course for my license and I used to go to the urologist for a routine check for five years even prior to being discovered and diagnosed with prostate cancer. I was that hyper focussed on earlier detection , if im going to get it ! My father was an engineer, very smart man, but hated doctors and never visited a doctor for 10 years at a time. He had to get a physical for an overseas project and that's when it discovered his PSA was about 18 or 20 I think it was. During his last six years of life I was his caregiver, as my mother and sister were too emotional around my father. I drove him back-and-forth from the hospital as he hated the hospital. I was with him to his last breath in heartbeat. Of course it took a lot out of me and gives me post traumatic anxiety at times. It's amazing, even my military experience flying active missions is less heavy on me and then look me up from my father during his last six months. I lose a lot of sleep over that. That happened over 25 years ago as well. Anyway, I wish you the best and pray for you every day. God bless. James on Vanc. Island .

Sorry for the mis-information.
The Siteman Cancer Center in St. Louis said here:
https://siteman.wustl.edu/worlds-first-mridian-center-treats-1000th-patient-with-mri-guided-radiation-therapy/
that they were using the MRIdian and were extolling the benefits, then at the bottom of the page said "Update: ViewRay technology, including MRIdian, is no longer in use at Siteman Cancer Center or at any other cancer center. "

Clearly they had not updated this web page.

I'm glad to hear that there are options for this type of radiological therapy. I most fear the side-effects of a poorly focused, all-encompassing radiation treatment in my near future. I'd like to learn about the comparison of the two you had mentioned: Proton Beam Therapy and MRI-guided X-rays (or electrons).

@krs03
Maybe they didn’t feel they could get a good return on their investment by continuing to use it and pay $1 million a year for support.

There are many people on this website that have been treated with Proton successfully and they will share their own opinion, but for me, it came down to either the Mridian machine or Proton. If Proton had a built-in MRI, I might have chosen Proton. By not having the built-in Mri, the margins of treatment and exposure to more side effects were greater. I was not willing to take that chance.

Feel free to look up my saga. It’s not very positive, but outcome today is better.