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Salvage Radiation Therapy with or without ADT added?
Prostate Cancer | Last Active: 2 days ago | Replies (49)Comment receiving replies
@surftohealth88
I had intended to keep this thread up to date but there have been...complications. First, the recommended ADT (Orgovyx) is contra-indicated with my heart medicine (Flecanide); we are sorting that out with my cardiologist. Second, the MRI showed two potentially involved pelvic lymph nodes; we are waiting on PET scan results (6/2) before proceeding.
Here is what my RO recommended BEFORE the MRI was done (and other test results confirmed aggressive cancer): IMRT and IGRT to treat to approximately 66-70 Gy to the prostate bed. Treat nodes to 45 Gy.
Any reactions to those recommendations?
Replies to "@surftohealth88 I had intended to keep this thread up to date but there have been...complications. First,..."
@bikeman1
I know - everything has to be so complicated :(((. Just as one thinks that all is finally lined up, something has to happen to make it more challenging.
I am so sorry that your heart medication is not compatible with Orgovyx, what a bummer !!! I really hope that your PC team and your cardiologist will come up with good solution very soon. 🍀 I also hope that PSMA will show zero node positivity, but if they are positive, than they will perhaps add longer ADT use or add some Nubeqa to it.
Our RO also suggested 66 Gys total to the whole pelvic floor and nodes + 6 mos of Orgovyx. This is also preliminary plan - we are waiting for PSMA results (he had a scan Thursday) and MRI is to be scheduled. My husband started Orgovyx yesterday. We will know how he reacts to ADT in about 2 weeks when SA usually start to happen. Hopefully they will be tolerable *knock the wood 🧿.
All in all, we are also still going through testing and scanning phase 😞, still a lot of unknowns. The only comfort is that my hubby started with ADT.
Wishing you all the best and completely clean PSMA scan 🍀 ! Nodes sometimes get enlarged due to different things and perhaps it is just some inflammation going on which is very often the case.
@bikeman1
I am getting radiation for prostate cancer reoccurrence, I had a prostatectomy 3 years ago. They are including the lymph nodes with the prostate bed in the first part then doing additional to the prostate bed. I showed nothing on the psma test. They are giving 45 gray to the lymph node portion. I will complete this portion next Monday then will have 13 more sessions for prostate bed.
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@bikeman1
These are pretty standard recommendations when reoccurrence happens. 3 1/2 years after my prostatectomy, my PSA started rising, and I had 40 sessions of IMRT. They didn’t have IGRT 12 years ago or I would asked for that.
You also want the pelvic lymph nodes radiated. Pretty standard procedure.
Hopefully this will get your PSA down to undetectable for a while, and you won’t need ADT. Of course your doctor will Probably want you on it because of the aggressiveness of your diagnosis. See if you can use Darolutamide, One of the other glutamine instead. Enzalutamide Has been approved for use without ADT.
Another option might be estradiol patches, Which work as well as ADT but worked totally differently on the body. Not sure if your doctor is really up on them, Many will not approve.