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Salvage surgery or salvage radiation?
Prostate Cancer | Last Active: 4 days ago | Replies (44)Comment receiving replies
@prettypass2000
Didn’t realize you were in Europe. They do have their own regulations for prostate cancer treatment.
I think I mentioned I had never heard of anybody having that type of surgery, It could very well be something that is done in Europe.
@heavyphil Made some interesting points about the fact that doing the surgery would not necessarily get micro metastasis eliminated. Definitely something to consider. Doing Salvage radiation would radiate the prostate bed and lymph nodes, If the ones that are problematic are in the area of salvage radiation then that would take care of them. Otherwise, as mentioned, you could have SBRT radiation to them.
It would be interesting to know what is decided after you see an RO.
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@jeffmarc Yes, we live in Germany but using American private healthcare through my husband's employer. So, when we need a treatment approval, they use American approach to make a decision. When I submitted the documents for pre-approval, they requested my husband also see radiation oncologist before they make decision. It seems they want to compare notes between the two treatments. I do think they will favor radiation because there more "evident-based" studies. It seems lymph node dissection is one of the treatment for recurrence here, but it seems to be very limited studies.
You and @heavyphil are right about those microscopic metastasis. Upon discussion with another patient, he mentioned that sometimes the microscopic cells don't show up on scan because they're too tiny. It makes sense and makes me worried about doing surgery because it can miss those cells. I just don't want to put my husband through misery twice because the doctor said he highly recommended dissection and then do PSA test 6 weeks after. If it fails, he may need ADT or radiation or both. The limited studies I've found shows 40%-60% relapse after lymph node dissection.