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Recurrence Post RALP: Did a second opinion change your plan?
Prostate Cancer | Last Active: Apr 11 10:39am | Replies (58)Comment receiving replies
Nothing is finalized yet, but its looking like Orgovyx to start - maybe 2 weeks or so, then add apalutamide. the 2025 Balance NRG GU006 Study shows it really works well against Luminal B cancer. Initial conversations were 6 months, which may be a little short. Another discussion point. Darolutamide is emerging as one with slightly similar (slightly less) results but considerably lower side effects.
Radiation is one thing we really havent talked through yet. I would like to the a shorter course of 25 or so. With my risk factors probably will do radiate both to be safe. JHU is still using CT guided, no MRI-guided. From what ive read the benefit of MRI guided isnt as pronounced in salvage as it is on the prostate itself. JHU has invested in their proton baby, although i havent sensed a lot of pressure to go that way.
If i can answer anything else let me know.
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@mlabus3
I am very grateful for you insights and for sharing info about possible plan for salvage RT. My husband has uPSA that is slowly creeping up and depending of results that his next uPSA tells us, there will be talks about possible early salvage RT. His last uPSA was 0.026 but the first post op uPSA was 0.014 , so something might be brewing there (or not). He also had large cribriform, IDC and Decipher 1, and all of that makes me very nervous ( read freaking out).
There is a study from 2011 that claim that uPSA does not have the same predictive value as does regular PSA and it's doubling time so it gives me some comfort. BUT, with such high risk features one can not relax, no matter what.
My husband was considering adjuvant RT but was advised by surgeon and MO to wait and see how his PSA would behave and to give his body time to heal from surgery which we think was a good advice because he regained full continence.
His salvage would also be IMRT and his center also does not have Meridian (?) machine but RO is well known and probably would make a good plan.
Do you know if they will insert gold fiduciary markers inside your body and if they plan to use gel spacer for colon ?
Once again, thanks for all the help and info < 3.
PS: If you have any links for relevant research papers or results would you be so kind to attach them for me to read 🙏.