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Post RALP PSA - how concerned should I be?
Prostate Cancer | Last Active: Aug 30 12:29pm | Replies (15)Comment receiving replies
My husband 58yr is post RALP this July. Gleason 4+3=7 with adenocarcinoma spread to unclear margins of two out of 22 surrounding lymph nodes. He is classified as having Stage 4a cancer because of the lymph node involvement. Northwestern Medicine in IL is saying he needs 37 Photon VMAT - IMRT treatments with daily CBCT five days a week using an Inverse Treatment Plan along with Hormone Blockers/Therapy. He is 58 years young. I am crushed. Anybody else go through this or have comments to share? His first post op PSA came back at undetectable so that’s good. The oncologist are saying because he has lymph node involvement with UnClear Margins they want to move sooner than normal (start at 3 months post RALP instead of 4-6 months). They said this will give him a 71% chance of beating the cancer verses a 20% chance without the treatment.
Replies to "My husband 58yr is post RALP this July. Gleason 4+3=7 with adenocarcinoma spread to unclear margins..."
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It's early days and you've had a lotta stuff w weird even ominous sounding words thrown at you and your husband.
Bottom line-they seem to have caught it early enuff to treat; it successfully. By that I mean while he may not ever be "cured" he'll be around a long time with attention and treatnent.
Suggest you AI Google his case info and see what comes back
Sounds like they think it still may be in lymph nodes near or in the prostate bed and they're going to zap them. That often results in a complete cure. If it doesn't there's still lots they can do to go after any so called mircrometasis that's slipped out further
Today's PSMA PET detection technology let's them see the stuff at very low levels of manifestation so they can go after it
Have them explain the 71% figure- is it 71% he'll be completely cured or 71% that with the right treatments he won’t die of it but merely with it,
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The treatment options you have been given are quite normal for the prostate cancer reoccurrence your husband has had. The hormone therapy they are recommending will stop the cancer from growing and actually shrink it in most cases. That way, the radiation is more successful.
The sooner they do the radiation treatment the better. The surgery was not completely successful since the margins were not clear. They are using the appropriate medical procedures To extend your husband’s progression free survival.
After my surgery, at 62, my margins were clear, but it still came back after 3 1/2 years. At that time I had 7+ weeks of radiation.
There usually is no cure once you’ve had a reoccurrence of prostate cancer outside the prostate. Treating it properly can give you long-term remission, But it frequently comes back if hormone treatment is not continued for an appropriate amount of time. Even then, it’s probably in his bloodstream so it’s going to be around for life.
After radiation, there’s a good chance your husband will have a long time before reoccurrence. It was 2 1/2 years after my radiation before it came back, But for me it’s been treatable with hormone therapy and ARSI Drugs for nine years after that.
Prostate cancer treatment has improved greatly in the last few years. I started off with surgery 15 years ago and I’m still alive anfter 4 reoccurrences. People I know have no idea I have prostate cancer, Unless I tell them. The latest drugs work really well and there’s more new treatments coming out all the time.