Recurrence Risk After Radiation

Posted by broderbund1 @broderbund1, 10 hours ago

I'm 60........two 3+3 and one 3+4 with 10% pattern. MD Anderson radiologist consult and Dr said it is a very small area so AS certainly an option.

After the appt I'm somewhat more receptive to just having this thing treated with SBRT as Doc said 95% cure rate and chance of mine spreading or recurring very low. (btw...still waiting on 2 genetic tests to confirm lack of aggressive features)

Still struggling a bit on what happens if it does come back again. Surgeons will tell you it's a mess.....Urologist tells me of the 5% that come back half of those are treatable so maybe 1-3 out of 100 metastasize. Really would like to avoid surgery but some of these Urologists scare the hell out of you....know there's a chance of recurrence but seems pretty small and for the most part treatable.

Grateful for any thoughts here....I'm sure there are horror stories but seems like the most likely outcome is heavily weighted to be good for me with radiation.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

jeff Marchi | @jeffmarc | 7 hours ago

Here are some information About treatment after a radiation failure

People who have radiation as their primary treatment have been told by doctors that surgery isn’t really an option if there’s a reoccurrence. Other options are not really mentioned..

This study shows that both salvage focal therapy (HIFU and cryotherapy) and salvage surgery were equally effective at extending the life of a patient that started off with radiation.

Those that had focal therapy had fewer perioperative complications.
https://jamanetwork.com/journals/jamaoncology/article-abstract/2844900

Setters and Birds | @jonathanack | 7 hours ago

I am in a somewhat similar situation. 64 (61 when diagnosed). I have 6 tumors: 2 are gleason 7 (3+4) with cribriform; 4 are gleason 6. I have a decipher of .72. My oncologist (Joseph Wagner - early robotic surgeon - over 4k successful) advise that both surgery and radiation were 'equipoise'. At his suggestion I met with a radiologists (trained at Weil/MSK). I had hoped that surgery would be the answer. But since one was the same as the other, I opted for radiation: - faster recovery, better odds at maintaining continence, better odds at maintaining intimacy. SBRT - 5 Treatments - 120 days of orgovyx. I just finished and my psa is undetectable. MRI later this week. I am no expert and Many Others on this site have very good information (Heavy Phil, Jeff Marci, and others) that helped me through the ramparts of my situation. Among the best notes of advice, I received from our cohorts: Exercise (very helpful), Get a Second Opinion (huge help), undestand that nearly every form of prostate cancer is treatable - maybe not curable, but treatable and a near-normal life is very possible. I have to say that in many ways we are lucky we have prostate cancer and not some other form that has far more grim prospects. So many kids and others have found cancer at much to early a point in their lives. My bet is you will be fine - you'll be anxious (rightfully) and annoyed at the side effects...and you will be okay once things are complete. Best of luck and watch for others with much better insight than me on this site to answer your questions. Go Easy - Jon