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Prostox - learn about whether radiation will cause problems
Prostate Cancer | Last Active: May 13 11:43am | Replies (42)Comment receiving replies
My name is Jovan, I am 77 years old.
Clinical history:
- Prostate cancer: Gleason score 3+4, clinical stage T2b
- PSA before radiotherapy: 8.8 ng/mL
- Received one hormonal therapy injection before radiotherapy
- Completed radiotherapy approximately 3 years ago
PSA follow-up:
- PSA 2 years after radiotherapy: 0.2 ng/mL
- PSA 3 years after radiotherapy: 0.38 ng/mL
- PSA doubling time (PSADT): approximately 10–12 months
Current question:
I would appreciate your opinion regarding:
- likelihood of biochemical recurrence,
- need for additional imaging (MRI or PSMA PET),
- and whether continued observation or early treatment would usually be recommended in this situation.
Thank you very much for your time and consideration.
Best regards,
Jovan
Replies to "My name is Jovan, I am 77 years old. Clinical history: - Prostate cancer: Gleason score..."
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@boki01
The standard of care for radiation treatment is that the PSA must rise two points above the minimum it ever hit. Yours is rising very slowly, It may never reach two points above the minimum that ever hit.
When your PSA approaches 1 You could get a PSMA pet test To see if spread can be found somewhere and then it could be treated with SBRT radiation. It depends on what your doctor wants to do. Some will start to find spread sooner than others.
The reoccurrence could happen in the area where the prostate shut down to about 40% of its original size, Or could show up somewhere completely different and then SBRT makes sense.
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