Prostate Cancer: What treatments did you choose after surgery?

Posted by 403211th @403211th, Mon, Mar 18 12:58pm

I had robotic prostate surgery September 2018 at Mayo clinic Rochester MN. My PSA was 12.9 and Gleason 8. I had 2 positive lymph nodes out of 21. I just had a PSA test 6 months after surgery it is 0.05 which doc says is very good. But he is trying to convince me to do hormone therapy and also radiation. I would like to have more information on this if anyone has been through this. My radiation oncologist is recommending 39 radiation treatments and 2 to 3 years hormone therapy.

Hi @403211th, welcome to Connect. You'll notice that I added to the title of the discussion that you started to call it "Prostate Cancer: What treatments did you choose after surgery?" This is such an important topic as there are so many considerations and decisions to make regarding prostate cancer treatment and the weighing of potential side effects.

You may also wish to read through some related discussions like these ones:
– PSA Doubling Time Under Active Surveillance https://connect.mayoclinic.org/discussion/psa-doubling-time-under-active-surveillance/
– prostate cancer treatment choices https://connect.mayoclinic.org/discussion/prostate-cancer-treatment-choices/
– Prostate cancer treated with Leuprolide https://connect.mayoclinic.org/discussion/prostate-ancer-treated-with-leuprolide/
– Prostate cancer treatment: stereotactic body radiation therapy https://connect.mayoclinic.org/discussion/prostate-cancer-treatment/

I'd also like to tag fellow members who have made treatment decisions recently, like @jogger01 @tiss @speed7484 @klaken @mapleleafs @greywolf @hodagwi @tdrell @bboxer and @jerrymayo123

@403211th, I commend you for taking the time to do your research and get more information, as well as experience of others. What concerns or questions or possibly doubts might you have about the proposed treatment of radiation and hormone therapy?

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The combined therapy of ADT and SRT to the Prostate bed for recurrence after surgery is becoming more mainstream in clinical practice.

This is because of the synergy when combining the two. There is also the issue of systematic vs focal disease. You may have systematic (micro metastatic) disease outside the proposed area of radiation that is too small to be seen on imaging such as the C11 Choline at Mayo so the ADT deals with that.

One thing to ask your medical team about is whether to include pelvic lymph nodes in the radiation treatment and if so, how high in the pelvic lymph nodes do they radiate? Mayo has data on that.

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@kujhawk1978

The combined therapy of ADT and SRT to the Prostate bed for recurrence after surgery is becoming more mainstream in clinical practice.

This is because of the synergy when combining the two. There is also the issue of systematic vs focal disease. You may have systematic (micro metastatic) disease outside the proposed area of radiation that is too small to be seen on imaging such as the C11 Choline at Mayo so the ADT deals with that.

One thing to ask your medical team about is whether to include pelvic lymph nodes in the radiation treatment and if so, how high in the pelvic lymph nodes do they radiate? Mayo has data on that.

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@9876 I think you'll appreciate @kujhawk1978's post in this discussion above. You were asking about radiation (salvage radiotherapy (SRT) and hormone therapy, otherwise known as androgen deprivation therapy (ADT).
Click VIEW & REPLY in the email notification to see the previous posts.

Good point about asking the radiation oncologist about pelvic lymph node involvement in the radiation treatment, @kujhawk1978.

Liked by Al

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I will and is it important to get a second opinion?

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@9876, members here on Connect often recommend getting a second opinion, especially when you have a complex diagnosis or you want to confirm or consult on available treatment options. Mayo Clinic researchers looked into the value of second opinions. You may be interested in reading this:
– Mayo Clinic researchers demonstrate value of second opinions https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-researchers-demonstrate-value-of-second-opinions/

All the best with your appointments today. Let us know how you're doing with starting Firmagon (degarelix).

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@colleenyoung

@9876, members here on Connect often recommend getting a second opinion, especially when you have a complex diagnosis or you want to confirm or consult on available treatment options. Mayo Clinic researchers looked into the value of second opinions. You may be interested in reading this:
– Mayo Clinic researchers demonstrate value of second opinions https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-researchers-demonstrate-value-of-second-opinions/

All the best with your appointments today. Let us know how you're doing with starting Firmagon (degarelix).

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In response to the Firmagon treatment. So far very little side effects after the third week. Small hot flashes that do not last more than a minute. It did do some weird things with my thinking soon after the shot. It is hard to explain but it changed my disposition somewhat. I felt more anxious and more tired at the same time. That seems to have gone away, but I do seem more tired. All that aside minimal side effects so far. I was told my next treatment will be Leupron. Will see how that goes.

Liked by Al

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@403211th

In response to the Firmagon treatment. So far very little side effects after the third week. Small hot flashes that do not last more than a minute. It did do some weird things with my thinking soon after the shot. It is hard to explain but it changed my disposition somewhat. I felt more anxious and more tired at the same time. That seems to have gone away, but I do seem more tired. All that aside minimal side effects so far. I was told my next treatment will be Leupron. Will see how that goes.

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Thanks for the reply. My next shots will be trelstar.

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