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What is best next treatment after 20 years of active surveillance?
Prostate Cancer | Last Active: Oct 16, 2025 | Replies (20)Comment receiving replies
@heavyphil
Salvage radiation is used to radiate the prostate bed when somebody’s PSA is around .2. His is 1.1.
His PSA is too high, and his cancer is in more places than the prostate bed. As a result, salvage radiation doesn’t really make sense. Targeted SBRT would make more sense, But even that may be inadequate.
Replies to "@heavyphil Salvage radiation is used to radiate the prostate bed when somebody’s PSA is around .2...."
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@jeffmarc Seemed like the disease was confined to the prostate bed (along the rectum and at an anastomosis) -
And a single iliac node.
My thought was that ADT could shrink this even more, followed by radiation to the bed and pelvic nodes - with possible SBRT to anything outside the range of standard SRT.
Also, are you saying that anyone with a PSA of 1.1 can’t have SRT? I would think that while a PSA of 0.2 or less is ideal, the term SRT is not PSA specific; but more descriptive of a lower dosage multi treatment regimen targeting the bed and nodes; anything outside of that area would be treated focally with high dose SBRT to avoid damage to surrounding structures. Is this incorrect? Thanks,
Phil