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Radiation result interpretation

Posted by Roxy2017 @roxy2017, Sep 29 9:38am

How long does radiation continue to "work" after treatment?

Gleason 8 Biopsy in Jan. PET in March showed two potential bone metastases both small -- one in pelvis and one rib. Also one lymph node by prostate. Went on Orgovyx and Xtandi on 3/10. Radiation in May to prostate and node. PSA is now negligible. New PET shows no new spots and substantial reduction if not elimination in others. Will those continue to go down? Is this of concern? Will meet with radiation oncologist next week. Example: Prostate was 10.5 SUV before and is now 3.5 SUV.

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jeff Marchi | @jeffmarc | Sep 29 11:06am

Radiation doesn’t kill everything immediately, Some people wait two or three years for their PSA to hit rock bottom after radiation . Radiation damages the cancer cells so that they start to die.

If you had a radiation to the prostate, it should have been eliminated as an issue. Was it not totally radiated? If it’s still there, it could be spreading further cancer. Then again, it could just be slowly dying as mentioned above. Ask the RO If the prostate was completely treated, If so, it’s just a matter of time.

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Roxy2017 | @roxy2017 | Sep 29 11:40am

Thanks will ask to clarify. I thought it was getting totally radiated so hopefully I am good to go.

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Roxy2017 | @roxy2017 | Oct 10 12:11pm

An update on this. Saw the RO today he was very pleased with the results of the PSMA PET scan. Said SUVs should continue to decline in treatment areas so he wasn't concerned about the node or the prostate at this time. He suggested that I have two options going forward. First active monitoring with a PSA every three months. If my PSA become noticeable then scan again to determine where to zap for the metastases. Second, zap the two metastases now that hadn't been zapped previously. In either case it would be 5 doses with minimal risks for side effects given the locations. He also said that with the Gleason 8 I should stay on the Orgovyx and Xtandi for two years regardless. I asked what he would do and he declined to say. He called it an emotional decision and whatever path I chose was the right call for me. Your thoughts? TIA

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heavyphil | @heavyphil | Oct 11 8:10am
In reply to @roxy2017 "An update on this. Saw the RO today he was very pleased with the results of..." + (show)
Profile picture for Roxy2017 @roxy2017

An update on this. Saw the RO today he was very pleased with the results of the PSMA PET scan. Said SUVs should continue to decline in treatment areas so he wasn't concerned about the node or the prostate at this time. He suggested that I have two options going forward. First active monitoring with a PSA every three months. If my PSA become noticeable then scan again to determine where to zap for the metastases. Second, zap the two metastases now that hadn't been zapped previously. In either case it would be 5 doses with minimal risks for side effects given the locations. He also said that with the Gleason 8 I should stay on the Orgovyx and Xtandi for two years regardless. I asked what he would do and he declined to say. He called it an emotional decision and whatever path I chose was the right call for me. Your thoughts? TIA

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@roxy2017 My own feeling is that if you have 2 suspicious spots (rib, I think?) and SE’s Are minimal, ZAP now….why wait?
The ADT is trickier but you probably should stay with it for a year and then re-assess the situation. Just my thoughts on what I would do, not medical advice. Best,
Phil

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lag | @lag | Oct 11 8:21am
In reply to @roxy2017 "An update on this. Saw the RO today he was very pleased with the results of..." + (show)
Profile picture for Roxy2017 @roxy2017

An update on this. Saw the RO today he was very pleased with the results of the PSMA PET scan. Said SUVs should continue to decline in treatment areas so he wasn't concerned about the node or the prostate at this time. He suggested that I have two options going forward. First active monitoring with a PSA every three months. If my PSA become noticeable then scan again to determine where to zap for the metastases. Second, zap the two metastases now that hadn't been zapped previously. In either case it would be 5 doses with minimal risks for side effects given the locations. He also said that with the Gleason 8 I should stay on the Orgovyx and Xtandi for two years regardless. I asked what he would do and he declined to say. He called it an emotional decision and whatever path I chose was the right call for me. Your thoughts? TIA

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My husband has been in the same situation in the past. He wanted to treat immediately the spots that showed up. He chose to zap the spots immediately and also to stay on the medications as suggested by his doctors, and of course to do the PSA tests every three months and scans when the PSA rose appreciably. When something showed up down the road, it could be dealt with quickly once again. This cycle has kept him alive for 20 years after his initial diagnosis. Good luck to you and hang in there.

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