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← Return to prostatectomy vs radiation?
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There are many different types and doses of radiation, of course, but I'd hazard a layperson's guess that if your PSA starts rising again after a large, "curative" dose of radiation to the prostate, the culprit is more often outside the prostate (so it wouldn't make sense to try to remove it anyway).
Replies to "There are many different types and doses of radiation, of course, but I'd hazard a layperson's..."
@northoftheborder
Hope you guys are still our friends up there! I took several cruises out of Vancouver and loved Canada.
I agree with you. I sometimes crinch when I hear posters post they only had radiation on certain areas of prostate. My R/Os at Mayo and UFHPTI stated they radiate all areas of prostate and will add margins.
Why I asked? Because a biopsy will only show the cells where taken. It is almost impossible to take a biopsy of all cells in prostate. So you might miss a part of prostate that has cancer so we radiate all of prostate and margins regardless of the specific areas found by biopsies.
I researched this to find we are talking about cancer at a cellurar level. So my little prostate got radiated along with my margins. It seems to have worked as my PSA last test was .10 when before treatments was 3.75.
I agree with your assumption of the culprit being outside prostate when PSA rises. I think that is one of the things my urologist, PCP, and R/Os looked at when we all thought radiation was best treatment for me.
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More often, but not always, unfortunately *sigh With cribriform and IDC things get dicey.
https://www.sciencedirect.com/science/article/pii/S0893395222002629
Also :
"Herein, we analyzed radiorecurrent cases of PCa in patients who underwent salvage RP and proceeded to demonstrate that tumors without treatment effect are enriched in both cribriform PCa and IDC-P, collectively referred to as cribriform morphologies, and exhibit genomic alterations that are often seen in advanced PCa. Our observations suggest that these recurrent tumors are likely driven by treatment-emergent clones that are either absent prior to the initiation of treatment, or present with an increased survival advantage relative to the pretreatment state. Understanding the phenotypic and genotypic diversity of recurrent PCa following RT is critically important to understanding radio-resistance and facilitating optimal patient management."