Anyone had salvage radiation therapy post-prostatectomy?

2/3 of the time the doctor say that the metastasis are not in the area where salvaged radiation is done.

I’m not sure how you Come up with saying 2/3 are working. This means that 2/3 of the time the metastasis are not being addressed and 1/3 of the time they are able to zap metastasis that are in the salvage radiation area.

Radiation to prostate bed after surgery for removal. Worked for 16 years. Having a recent climb with bone metastasis. Now on Xgeva and Xtandi.

Also, the SPORTT trial showed that radiation to the pelvic lymph nodes was essential for SRT to be successful - up to that point only the bed was being treated and there was a 30% failure rate.

I guess that is the question. If your PSA was starting to go up, and doing SR dropped it, then wasn’t that the area the problem was in.

For me, it worked for 2 1/2 years. PSA went from .2 to undetectable. As slow as it grows, that could be the amount of time that it takes to grow in a different area, something that had been too small to be seen 2 1/2 years ago.

That leaves out completely how you could go 16 years, that’s a result of Dormancy. Cancer cells can go dormant and not reappear for years or decades. Isn’t that great to know?!!! Arghhh.

I had salvage radiation of the prostate bed after a prostatectomy to treat the tissue which may had had cancer. Multiple testing for 10 years confirms it was a smart thing to do.
In reading several comments in this threat, I have a question fir each of you. If, this targeted beam radiation helps 1/3, or 2/3 or whatever/3 of the patients , I consider those as pretty good odds of helping. Why wouldn't a patient want this procedure? There's a 100% chance it won't help at all if this procedure it not performed.

The reason that somebody would want to avoid this treatment is that radiation does damage to organs that are not the target. Urinary and bowel problems happen after doing radiation for many people. Five years after salvage radiation, I started having incontinence problems. A know an issue with radiation.

Some doctors, swear by the fact that you can just zap the metastasis as they come up and you don’t need salvage radiation.

This may be true for some people, Problem is it’s hard to know who it’s true for.

Sorry to hear about your reoccurrence. My surgery was 3 years ago and my blood work today showed a PSA of .24....
I guess I'll be given salvage radiation next. I don't know.

The best results are frequently after you have had salvage radiation. Here is some information about the importance of getting treated in time, starting with .2. it seems to imply that you are at the point that you need to make a decision right away.

From Ascopubs about what PSA to do salvage radiation.
≤0.2 ng/mL:
Starting at this level maximizes disease control and long-term survival. Patients treated at PSA < 0.2 ng/mL achieve higher rates of undetectable post-SRT PSA (56-70%) and improved 5-year progression-free survival (62.7-75%).
Delaying SRT beyond PSA ≥0.25 ng/mL increases mortality risk by ~50%.
0.2–0.5 ng/mL:
Still effective, particularly for patients with low-risk features (e.g., Gleason ≤7, slow PSA doubling time). The Journal of Clinical Oncology recommends SRT before PSA exceeds 0.25 ng/mL to preserve curative potential.
0.5–1.0 ng/mL:
Salvage radiation remains beneficial but may require combining with androgen deprivation therapy (ADT) for higher-risk cases.

Had total prostatectomy in 2015- PSA < .015. 2yrs later PSA had risen to .034. Had SRT. PSA dropped to .021 and then continued to increase over the years and reached .02 by 2025. Looking at PET scan and whatever that reveals. My urologist and radiologist cannot offer an explanation other than to tell me that this will not kill me. The surgeon said that everything went fine and I should be fine. 2yrs later the radiologist told me that he would wipe out any remaining cancer cells, yet here we are.

Your PSA is too low for a PSMA PET scan to be useful, It won’t find anything. Your PSA should be at least .5 before you consider A PET scan, though a doctor may go a little lower.

A .02 PET scan is really undetectable and not an issue you should worry about yet.

I had surgery 3 1/2 years later my PSA started rising. I had salvage radiation. 2 1/2 years later my PSA started rising above .2, At that point, they put me on Lupron (ADT). You are not even close to that so you really need to wait for future tests to show if you really have a PSA increase.