Only Radiation Therapy?

I know people with Gleason nine that have not had their cancer come back after radiation for 15, 20 and 25 years. I know other people that have had it come back within a very short time.

The severity of your prostate cancer case is a major issue, You provided no information.

Radiation and surgery are about equally effective in terms of overall and progression-free survival for early-stage prostate cancer. Neither offers a 100% guarantee, and each has pros and cons.

For advanced-stage prostate cancer, radiation is the only option, because they *know* that the cancer is no longer contained entirely in the prostate.

On the personal side, in October I'll have been 5 years in deep remission (no evidence of disease) with stage 4b oligometastatic prostate cancer. I had 20 gy of radiation to my spinal metastasis and 60 gy to my prostate, and have been on ADT and Erleada continuously since 2021.

@northoftheborder
Thanks for sharing your success story! Praise God 🙏🏽

@mikeg73
We are all different and how we respond to radiation is specific to you and your P.C. What R/Os and urologist can give you is statistics. Radiation treatments these days are highly precise but they only radiate what the R/O has set up.

I know I asked my R/Os this question: Did you radiate on the areas identified in the biopsies or the whole prostate? Answer: "I radiated your entire prostate and margins" I do that after 20 years of doing this to ensure we don't miss an area that was not caught during your biopsies."

So you can see each person is different and up to your urologist and R/Os the type of treatment you get. I am not 3.5 years after my radiation treatments ended and my PSA is undetectable.

Stay positive and believe like me your treatment will irradicate the cancer and was caught early enough and had not moved beyond your prostate.

Even when a person has surgery it does not mean the P.C. was cured. As the cancer cells could have been outside the prostate and removing it only erraticated the P.C. in the prostrate as it was removed.

Good luck, The new highly advanced radiations have extremely high success rates. Again per my Mayo and UHFPTI R/Os and PCP.

With success rates comparing surgery with external radiation for localized prostate cancer being statistically equivalent no matter which treatment is chosen (https://www.nejm.org/doi/full/10.1056/NEJMoa2214122), it all comes down to side-effects that one is willing to deal with and quality-of-life priorities (or as that paper concludes, “… the choice of therapy involves weighing trade-offs between benefits and harms associated with treatments for localized prostate cancer.”).

With external radiation, if (heaven forbid) there is a local recurrence, there are a number of salvage options.

(I was diagnosed with prostate cancer in April 2012, was on active surveillance for 9 years, had proton radiation treatments during April-May 2021, and now 5y3m post-treatment, my most recent PSA was 0.366 ng/mL. Now at 71y/o, I have every expectation that these good results will continue.)

@jc76 Yes, the focus (or lack thereof) really makes a difference.

("Glass is half empty") My RT spread beyond my prostate and gave me mild radiation cystitis and proctitis.

("Glass is half full") My RT spread beyond my prostate itself to deal with any hidden cancer cells lurking in my prostate bed, bladder neck, and rectum.

I'm more of a half-full guy. 🙂

No experience but I start radiation next week. Given the aggressiveness of my PC, I was told radiation alone has an 80% success rate, 85% if combined with ADT. I've seen other posts for less aggressive cases where people were told 90%/95%. The problem is these are averages. Factors that could be critical, like age or other medical problems, are not mentioned. During the initial consult with the radiation oncologist he either does not know how age factors in or does not want to tell me.

You should be aware greatly complicates/precludes prospects of subsequent prostatectomy. I chose radiation, but I wasn't going to ever consider prostatectomy.

@htexsp That makes sense, since if there's recurrence after prostatectomy or RT, there's a good chance it's coming from outside the prostate anyway (100% chance after a prostatectomy, of course).

Right now I'm waiting for my decipher score which hopefully will lead me in the right direction 2 cores 3+4, .8cm lesion oncologist said 90% effective without adt if it comes in low to medium will probably do the sbrt 5 treatments every other day. If on the higher end probably will opt for nerve sparing surgery because if there is reoccurance would probably be more options.