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Cancer in Prostate and Seminal Vesicles: Prostatectomy or SBRTw/ADT?

Prostate Cancer | Last Active: 17 hours ago | Replies (26)
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Profile picture for surftohealth88 @surftohealth88

@heavyphil

I have no idea how it came to be that patients started to believe that RT patients do not have BCR ??? O-o

It happens about 10% less in RT BUT one can not irradiate the same spot twice and salvage surgery is almost impossible.

Also, RT patients are inherently older cohort in general and many die from other reasons than PC which removes them from study, so real % of total BCR happening is skewed.

RT for aggressive cancer is even more iffy with results (about 36% have BCR in 15 years according to the latest JAMA article 2023).

The famous "Steve" case with cribriform surviving brachy was a tipping point for me (for my husband brachy was never even "in the picture" lol, he was "take it out guy" from the 3+3 stage). He is especially happy now that he has a second chance to eradicate it IF it really proves to be BCR.

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Replies to "@heavyphil I have no idea how it came to be that patients started to believe that..."
jeff Marchi | @jeffmarc | 17 hours ago

@surftohealth88

Another thing to consider is that when somebody has BCR after RT it doesn’t necessarily happen in the prostate tissue.

But

People who have radiation as their primary treatment have been told by doctors that surgery isn’t really an option if there’s a reoccurrence. Other options are not really mentioned..

This study shows that both salvage focal therapy (HIFU and cryotherapy) and salvage surgery were equally effective at extending the life of a patient that started off with radiation.

Those that had focal therapy had fewer perioperative complications.
https://jamanetwork.com/journals/jamaoncology/article-abstract/2844900

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