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ProstoxUltra & Prostox CFRT both high risk-switch to RALP?
Prostate Cancer | Last Active: 14 hours ago | Replies (18)Comment receiving replies
The study I am thinking of was mentioned on Inspire. I will get a link to it. But first you have to define equal outcomes. If by equal, you mean time to death then yes, RP and radiation yield equal time to death on aggregate. But there is a big difference between your last years dying from a distant metastasis or just dying from other natural causes. And that is the key difference between an RP and radiation. With an RP there is a greater chance of ultimately experiencing a distant metastasis than there is from being initially treated with radiation.
Replies to "The study I am thinking of was mentioned on Inspire. I will get a link to..."
@wwsmith
I forgot that my own case sort of disagrees with the logic of what you’re coming up with.
I had surgery 16 years ago and 3 1/2 years later my PSA started rising so I had salvage radiation. 2 1/2 years after that I had to Go on Lupron because my PSA started rising again. Became castrate resistant 2 1/2 years later.
I’ve been on a variety of drugs since then. Five years ago I found out I have BRCA2, which is why it keeps coming back.
Two years ago a metastasis Wrapped around my L4 on my spine was zapped with three sessions of SBRT. Since then, I’ve been undetectable for the last 25 months while on Orgovyx and Nubeqa. When Nubeq Stops working I can start with a PARP inhibitor. When that stops working, I can have Pluvicto and/or chemo. I don’t think I’m going anywhere soon.
Starting off with surgery gave me 3 1/2 three years before it came back. If I started off with radiation, it probably would’ve been a lot less than 6 years before I would’ve needed to go on Lupron
Maybe I’m just one case, But with BRCA2 it’s an aggressive case and surgery her seemed to extend my survival time.
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@wwsmith you said “ With an RP there is a greater chance of ultimately experiencing a distant metastasis than there is from being initially treated with radiation.”
There seems to be some reasoning behind this, but, Tests have shown that people that have RP’s are more likely to have better survival after having a DM. This also seems to be true in more advanced cases, not cases were the cancer as isolated to the prostate without advanced issues.
Recent studies, especially for high-risk localized prostate cancer (PCa), suggest radiotherapy (RT) may actually provide a lower risk of distant metastasis (DM) compared to radical prostatectomy (RP), contradicting the idea that RP is better; some research indicates RT-based treatment significantly lowers DM risk, while other analyses show similar overall outcomes but with RT potentially controlling progression better in unfavorable cases, though RP offers better survival after metastasis develops.