Questions regarding Radiation treatment after ADT & Prostatectomy

Posted by benice268 @benice268, Sep 7, 2023

A 64 old with GS 4+3 T3B with a positive margin. Overall healthy. Urologist said it's high risk & aggressive. Had prostatectomy surgery in April but was told cancer escaped to seminal vesicle. PSA rose from 0.047 in June to 0.067 in July. Oncology suggests ADT & Radiation treatment. Radiation will target the pelvic bed. Just finished Bicalutamide for 30 days and had 6-month ADT hormone shot on Aug 18. PSA was 0.0042 (on Aug 16) after Bicalutamide but before ADT. It went down to 0.023 after ADT. It's been 5 months after surgery. Still have urinary incontinence with 1 pad a day.

Just worry UI will get worse after radiation. Before making a decision on when to start 20 rounds radiation over 4 weeks, have some questions and hopefully someone can help:
- Anyone experience light headache in the middle of the night after ADT? Headache usually goes away in 5-10 minutes. However, this interrupts the sleep.
- How long usually wait after ADT to do radiation? Rad Onc suggested early Oct.
- How to tell if urinary incontinence not getting better (- I know it is a silly question)? Right now, light jogging & fast walking will leak. Also if there is a urge to go & can't find a bathroom, it will leak a bit. Still need to go 1-2 times at night.
- Will radiation make urinary incontinence worse? If yes, will it recover to the state at least prior to radiation?

Thanks

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benice268 | @benice268 | Sep 19, 2023

In reply to @bettwils16 "Hi, what has your PSA been since you finished radiation?" + (show)

He has not started rad yet because still recovering from COVID.

bettwils16 | @bettwils16 | Sep 19, 2023

In reply to @benice268 "He has not started rad yet because still recovering from COVID." + (show)

Good luck. My husband finished 38 radiation treatments March 20th. No problems at all except for being tired. PSA after was 0.02 in June and Sept. Hang in there

benice268 | @benice268 | Sep 20, 2023

In reply to @bettwils16 "Good luck. My husband finished 38 radiation treatments March 20th. No problems at all except for..." + (show)

Do you mind if I ask what Gleason score your husband has and did he have prostatectomy and ADT before the radiation?

firespooks | @firespooks | Sep 21, 2023

I had 39 radiation treatments to my prostate bed , in 2013, 7 years after my prostatectomy. I did not have ADT. I still get frequent urges to urinate and I have to wear 1 pad every day. My Urologist said I should just tolerate it.

bettwils16 | @bettwils16 | Sep 21, 2023

In reply to @benice268 "Do you mind if I ask what Gleason score your husband has and did he have..." + (show)

Hi, Gleason score 4 + 3 = 7. Yes, he had a prostatectomy 2008, clean margins. No ADT, Urologist/Surgeon and Rad Oncologist both agreed it wasn't necessary. He'll be getting PSA every 3 months for a year.

benice268 | @benice268 | Sep 22, 2023

Thanks both bettwils16 and firespooks.

My father feels something is blocking the tip of his penis when he pees. It is very mild and only at the beginning of peeing and the pee still comes out fine. Urologist suggested and my father will have Cyctoscopy to examine the lining of his bladder and urethra in two weeks. He still has urinary incontinence and needs 1 pad a day after RP & AD & hormone injection. I wonder if someone knows will Cyctoscopy make UI worse?. He is scheduled to do radiation in about a month time.

Thanks,

Colleen Young, Connect Director | @colleenyoung | Sep 24, 2023

In reply to @bbqman "After a RP and two bouts of RT, I eliminated all caffeine from my diet. That..." + (show)

Hi @bbqman, how long ago did you complete treatments? How are you doing now?

bbqman | @bbqman | Sep 24, 2023

Hi Colleen,

I had a RP in December, 2014. I had biorecurrent PC in February, 2015, followed by 8 weeks of radiation between May-July, 2015. Have been on intermittent Eligard treatments since. Recently, my PSA spiked. I had a PSMA Pet Scan which revealed a pelvic sidewall lymph node measuring 1.8 x 1.3 cm with marked radiotracer uptake. Subsequently, had an additional eight weeks of radiation and an additional course of Eligard. I’m doing fine surrounding by a fine team at Johns Hopkins where I am being treated. Thank you for asking.