Salvage radiation decision: with or without hormone therapy?

I didn't want to do the hormone therapy along with radiation. But, as many have said, why play around with this? So I'm doing it. Almost Half way through a 6 month regimen of orgovyx. Not fun ,but on the whole very manageable. Also , my oncologist really talked me into it.

Hey! Thanks for getting back. Yes, all lymph nodes were clear after surgery. I'm still on Eligard. Just had my 2nd of three 6 month shot 2 months ago so I have a bit to go before I'm off ADT. My PSA rose to .9(started at .2) within 9 months of surgery. I'm feeling great, well outside of the side effects of Eligard, but I'm real worried about when the ADT stops. Thank you so much for reaching out.

i think that's right ,Phil.

I found this on AI

Yes, when considering salvage radiation therapy (SRT) with androgen deprivation therapy (ADT) for recurrent prostate cancer, a 5-year freedom from biochemical progression rate as high as 87.4% has been reported in a phase 3 randomized controlled trial. This study, the SPPORT trial, evaluated SRT to the prostatic bed and pelvic lymph nodes, combined with a short course of ADT. This was the experimental arm in the study, and it showed a higher freedom from progression rate compared to SRT to the prostatic bed with ADT (81.3%) or SRT alone (70.9%). The SPPORT trial indicated that SRT plus ADT offered a benefit in progression-free survival.

Understandable your worry; doesn't make it easier.
We have been traumatized by our PSA (AKA prostate specific anxiety).
In my case , I trust that the salvage radiation did its job and the ADT assisted.
And while I was very glad to complete the ADT portion of the treatment, I was worried every 3 mos thereafter whether the ADT effect had ended and would my PSA rise again.
Well my PSA remains undetectable 2 years after completing ADT.
And I hope for a long remission, but believe that there is continued and additional treatment available if/when I recurr.
And enjoy my current good health. That's the best I can do and that's a great gift.
Best wishes

Yes. I was grateful that this study was done; just makes all kind of sense to do it all at once and get it done.
Phil

I have 4 more radiation treatments left and have a PSA Wed. I've been told it my not be 'undetectable' because it sometimes takes 4 to 8 weeks for the radiation to kick in. Really hoping it is undetectable, though.
There are 5 of us who are getting radiation at about the same time and the biggest complaint is the prep. Bladder full and bowels empty. Took me 20 times, but I think I FINALLY have a 'system' down.

Congrats on finishing your journey through this treatment! Hoping your PSA is undetectable and you are cured!!

I'm so happy to hear about your PSA levels! Keep it rolling! That's GREAT! BTW, I love your description of PSA! hahaha I guess if I KNEW there was a definitive plan of attack if it recurr's I'd be in a good place. But messages like yours helps a lot. It really does.

Keep that PSA low and stay in touch. This has a been a great help to me.

Doug

You say in another message that your PSA dropped to .01. In this message, you say it went to .9. If your PSA is rising after surgery, while you are on ADT, Then you have become castrate resistant and need a second drug, but you’re already on it. Is your PSA rising even though you are on Elgard?

If it’s truly .9 now you must have a metastasis that is growing. Sounds like time for a PSMA pet scan to see what’s going on.

After surgery, my PSA stayed at < .1 for 3.5 years. I had salvage radiation and my PSA stayed undetectable for 2 1/2 years. Yours should stay that low after salvage radiation too.

This may just be a case where you need some Metastasis Zapped with SBRT radiation.

Hi Jeff. Sorry about the confusion. Here is a timeframe.

11/23 - RP surgery
3/24 - First PSA post surgery was .2
6/24 - PSA .5
9/24 - PSA .6
12/24 - PSA .9 (or thereabouts)
12/24 - Doc then started me on Eligard and radiation began 2 weeks later.
2/25 - PSA .02
5/25 - PSA .01

All pet scans have come back clean. I think I've had 3 of them. The last one was just before I began the radiation to make sure the prostate bed was the only point of concern.

There ya have it. I hope I've cleared up some things

And THANK YOU again.
Doug