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ProstoxUltra & Prostox CFRT both high risk-switch to RALP?
Prostate Cancer | Last Active: 13 hours ago | Replies (18)Comment receiving replies
I think the newest studies underway will show lower chances of recurrence with modern radiation and ADT use than with RP treatment. You can already see it on an anecdotal basis by just counting how many RP posters on the various forums have a recurrence versus those that started with radiation.
It is also incorrect to say that initial radiation treatment precludes future radiation treatment. You can see numerous cases on this forum where SBRT is used multiple times because it is so precise.
If a patient has significant risk factors before initial treatment, an RP is in most cases ill advised because follow-up radiation is almost guaranteed. Why go through an RP when you know recurrence and future radiation is almost certain?
The primary problem with an RP is that it only deals with cancer contained within the prostate itself. All of the recurrences you see after an RP came from microscopic escapes of cancer cells from the prostate gland that could not be detected before the RP was performed. This happens with far greater frequency than what the surgeons advise patients.
With radiation treatments, if there is any suspicion that some microscopic escape of cancer has already occurred, radiation can target not only the gland itself but also the greater pelvic region such that those as yet undetected microscopic cancer cells can be killed.
Replies to "I think the newest studies underway will show lower chances of recurrence with modern radiation and..."
@wwsmith
What study are you referring to that says radiation Is that much better than RP. I’ve not seen anything like that recently, The PCRI conference last month didn’t discuss it. The studies I’ve seen have shown that both of them are equally successful long-term.
When people here mention not being able to radiate twice, they’re talking about radiating the same area that was radiated by either initial radiation or salvage radiation. That radiation is considered the maximum you can have in that area for the life. It’s a well-known fact that SBRT can be used to metastasis that are not in that area.
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@wwsmith
We can not rely on "anecdotal" data on this site since it is anecdotal. Actually just this year there were several cases here of RT patients (and 2 with proton radiation) that had BCR and were scared to death and asking for guidance since there were not many options on the table. Also, no, you can not radiate prostate again - SBRT is used for recurrence in the areas around the gland or other places where mets appear after initial RT. If there are new methods indeed than imagine what toxicity second round can cause on the same place ?
Why have RP - for some cases it is a better method that provides much better results. My husband had IDC and cribriform and those formations sometimes show resistance to RT and actually post RT examination in those cases in some studies found mutated cells that were even more aggressive in nature.
He might have BCR anyways in 5 years , but any year without ADT and possible RT side effects that can be debilitating and long term is a plus for him. He is very active in sports and works full time and has 2 startups on top - brain fog, low energy, cistitis, proctitis, secondary cancers etc etc were something far less appealing to him than surgery and he is very happy with his decision. He had consultations with both surgeon and radiologist and BOTH in his case advised RP to him in the top center for PC treatment . And that is "why".