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Starting radiation & hormone tx for recurrence: Your experience?

Posted by natem @natem, Feb 13, 2022

I have been advised to start 7.5 weeks of radiation and 6 months hormone treatment for recurrence after 8 years post prostatectomy. Had a Gleason 9 when removed, but did not spread to lymph nodes, nor semi vesicles. May annual PSA came back at .3 after having been <.1 fifteen months prior. My fear is what if I have to stay on because it spread somewhere else and the side effects of hormone. I'm 61 yo. Any thoughts, suggestions, experiences? TIA!

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kujhawk1978 | @kujhawk1978 | Mar 18, 2022
In reply to @natem "May I ask, how were you able, or what brought your psa down when it rose..." + (show)
@natem

May I ask, how were you able, or what brought your psa down when it rose to .29 Jan 21, 2021 and .3 on May 1, 2021? Best wishes for your continued success. Kind regards, Nate

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Nate

That's the "art" of this damn cancer...my urologist has no idea and when I poke around the various forums and trusted web sites., I don't find a similar clinical history.

I have labs next week, I call it "let's make a deal, what's behind door #1"

I have read some studies about the role of exercise in PCa, reducing inflammation, strengthening the immune system allowing it to fight off PCa when it's in a minute stage and can be fought off by one's immune system. Conjecture though.

For now, the variability in my PSA reinforces mine and my medical team's decision not to pull the trigger for one or two data points.

I do follow the same "routine" prior to each PSA, use the same lab, at the same time if the day...

Sorry, not much help!

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natem | @natem | Mar 18, 2022

Thanks, that is much help. I survived since 2005 without a heart transplant and can now walk, run a bit and bike on a machine. They had estimated 3-4 years to survive. I'm a believe in when it's at some early stages the body's immune system can fight it off. Maybe even sometimes it may be the feather that tips the scale. If you have any particular book, or diet book that's informative. I've asked my Radiation Oncologist to set me up with a dietitian. I find it interesting about not necessarily jumping to treat instantly, but I'm unskilled. Sounds like you have excellent guidance. Prayers for your next labs. I'm waiting on labs from a previous hpv throat cancer I had treated with radical surgery, dissection and radiation. It's a new test to catch recurrence earlier, but it's scary for me even though the rad Oncologist seems optimistic. I know test anxiety too well. Best wishes for continued success. I'm an open book should anyone have questions. I hope I can pay it forward. Thank you!

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fuzzyjeepster | @fuzzyjeepster | Jul 21, 2022

Diagnosed in July of 2017, with RP in Feb of 2018. Post op PSA levels were zero until Feb 2020, and today is around 1.0.
In July, (this month), I traveled from Colorado to UCLA and paid out of pocket for a PMSA scan, which shows PC only in the prostate bed region. There was discovery of lymph node activity after surgery, (they clipped 3 nodes- 1 was positive). My gleason was 7, (4+3), and the urologist stated the cancer was more aggressive than they initially thought, with PC breaking out of the prostate capsule, engulfing one set of nerve bundles. My PSA at time of surgery was around 8.5. The PSA started popping positive again at the 2 year mark. Now, 4 years later it is just above 1... (1.0 as of June)
My radiologist is recommending full on 7.5 weeks of prostate bed and lymph radiation, along with hormone deprivation, while the urologist, (now retired) was strongly recommending prostate bed radiation only for 5 days or so, for side effects and quality of life. Thoughts?

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3 replies
fuzzyjeepster | @fuzzyjeepster | Jul 21, 2022
In reply to @fuzzyjeepster "Diagnosed in July of 2017, with RP in Feb of 2018. Post op PSA levels were..." + (show)
@fuzzyjeepster

Diagnosed in July of 2017, with RP in Feb of 2018. Post op PSA levels were zero until Feb 2020, and today is around 1.0.
In July, (this month), I traveled from Colorado to UCLA and paid out of pocket for a PMSA scan, which shows PC only in the prostate bed region. There was discovery of lymph node activity after surgery, (they clipped 3 nodes- 1 was positive). My gleason was 7, (4+3), and the urologist stated the cancer was more aggressive than they initially thought, with PC breaking out of the prostate capsule, engulfing one set of nerve bundles. My PSA at time of surgery was around 8.5. The PSA started popping positive again at the 2 year mark. Now, 4 years later it is just above 1... (1.0 as of June)
My radiologist is recommending full on 7.5 weeks of prostate bed and lymph radiation, along with hormone deprivation, while the urologist, (now retired) was strongly recommending prostate bed radiation only for 5 days or so, for side effects and quality of life. Thoughts?

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I should add, the axium pet scan showed nothing, while the psma scan identified the location of the PC cells. Also- diagnosed at 55 yo, will be 60 next month.

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james1951 | @james1951 | Jul 21, 2022
In reply to @fuzzyjeepster "Diagnosed in July of 2017, with RP in Feb of 2018. Post op PSA levels were..." + (show)
@fuzzyjeepster

Diagnosed in July of 2017, with RP in Feb of 2018. Post op PSA levels were zero until Feb 2020, and today is around 1.0.
In July, (this month), I traveled from Colorado to UCLA and paid out of pocket for a PMSA scan, which shows PC only in the prostate bed region. There was discovery of lymph node activity after surgery, (they clipped 3 nodes- 1 was positive). My gleason was 7, (4+3), and the urologist stated the cancer was more aggressive than they initially thought, with PC breaking out of the prostate capsule, engulfing one set of nerve bundles. My PSA at time of surgery was around 8.5. The PSA started popping positive again at the 2 year mark. Now, 4 years later it is just above 1... (1.0 as of June)
My radiologist is recommending full on 7.5 weeks of prostate bed and lymph radiation, along with hormone deprivation, while the urologist, (now retired) was strongly recommending prostate bed radiation only for 5 days or so, for side effects and quality of life. Thoughts?

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Ok u might consider this treatment.
7 weeks (35 treatments). radiation 70 Gy. Add 3 3 month Lupron. Shots in addition to the radiation.

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Moderator
Colleen Young, Connect Director | @colleenyoung | Jul 23, 2022
In reply to @fuzzyjeepster "Diagnosed in July of 2017, with RP in Feb of 2018. Post op PSA levels were..." + (show)
@fuzzyjeepster

Diagnosed in July of 2017, with RP in Feb of 2018. Post op PSA levels were zero until Feb 2020, and today is around 1.0.
In July, (this month), I traveled from Colorado to UCLA and paid out of pocket for a PMSA scan, which shows PC only in the prostate bed region. There was discovery of lymph node activity after surgery, (they clipped 3 nodes- 1 was positive). My gleason was 7, (4+3), and the urologist stated the cancer was more aggressive than they initially thought, with PC breaking out of the prostate capsule, engulfing one set of nerve bundles. My PSA at time of surgery was around 8.5. The PSA started popping positive again at the 2 year mark. Now, 4 years later it is just above 1... (1.0 as of June)
My radiologist is recommending full on 7.5 weeks of prostate bed and lymph radiation, along with hormone deprivation, while the urologist, (now retired) was strongly recommending prostate bed radiation only for 5 days or so, for side effects and quality of life. Thoughts?

Jump to this post

@fuzzyjeepster, making decisions about treatment for prostate cancer are never easy. The 2 differing options presented to you are discussed by @natem @scullrower @kujhawk1978 @itterac in this discussion:
- Starting radiation & hormone tx for recurrence: Your experience? https://connect.mayoclinic.org/discussion/starting-radiation-and-hormone-treatment-for-recurrence-psa-3/

I moved your post to the existing discussion so you can read the past posts and connect easily with Nate and the others.

@fuzzyjeepster, are both radiation protocols that are recommended for you stereotactic body radiation therapy (SBRT)?

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