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Radiation risks following a TURP

Posted by normanosk @normanosk, Nov 6 1:49pm

Hello, My dad (age 79) was diagnosed with prostate cancer in June. Gleason score 9. Needed a TURP in early September due to significant urinary retention issues. The TURP relieved those symptoms, and he has responded well so far to his medication combination of Eligard plus Zytiga - PSA has decreased to 0.8.

His PET scan showed low volume metastasis, with several lymph nodes involved. Radiation oncologist says he is a good candidate for beam radiation directly to prostate, for best chance of positive outcome and driving the PSA down even farther.

But we are concerned about the TURP making the risk higher for urinary side effects, especially retention problems, and no real possibility for reversal of those side effects.

Is anyone familiar with the risks of radiation following a TURP? Is it higher and/or are there any success stories? Would radiation to the impacted lymph nodes be a better option than direct radiation to the prostate due to the risks?

Thanks for any thoughts!

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thmssllvn | @thmssllvn | Nov 7 9:07am

Oligometastatic disease is less than FIVE lesions and
SBRT can deal with them. Unmentioned is the 'PSMA'
PET CT results for the Prostate itself. I do remember
a PCRI.org video on Brachytherapy 101. They commented that even Turped patients can be treated
as there is usually enough tissue around to focus the
permanent low dose seeds safely away from urethra.
The key is to find a clinician who has done many many procedures. What did the scan show on the prostate itself.

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normanosk | @normanosk | Nov 9 6:38am
In reply to @thmssllvn "Oligometastatic disease is less than FIVE lesions and SBRT can deal with them. Unmentioned is the..." + (show)
Profile picture for thmssllvn @thmssllvn

Oligometastatic disease is less than FIVE lesions and
SBRT can deal with them. Unmentioned is the 'PSMA'
PET CT results for the Prostate itself. I do remember
a PCRI.org video on Brachytherapy 101. They commented that even Turped patients can be treated
as there is usually enough tissue around to focus the
permanent low dose seeds safely away from urethra.
The key is to find a clinician who has done many many procedures. What did the scan show on the prostate itself.

Jump to this post

This is helpful info, thank you. I have not read about brachytherapy so I will learn more and will look for that video. I don't know what the specifics were for the scan of the prostate itself, so will find out. Thank you for your comments!

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heavyphil | @heavyphil | Nov 10 6:52am
In reply to @normanosk "This is helpful info, thank you. I have not read about brachytherapy so I will learn..." + (show)
Profile picture for normanosk @normanosk

This is helpful info, thank you. I have not read about brachytherapy so I will learn more and will look for that video. I don't know what the specifics were for the scan of the prostate itself, so will find out. Thank you for your comments!

Jump to this post

@normanosk It should not be a problem. In fact, many men need relief from urinary symptoms via various procedures before radiation, since radiation itself can cause swelling and urinary blockage. So in that sense, he is in a better position now to receive treatment.
Also, radiation to the lymph nodes only would be counterproductive since the cancer is coming from the prostate gland itself.
Not targeting the gland would be a waste of time since cancer cells would invariably migrate back to the nodes and other parts of the body.
Phil

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