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Salvage Radiation Therapy with or without ADT added?
I am the point where I need to get Salvage Radiation Therapy. I had RALP in November 2025 and now, 6 months later, my PSA has presented an increasing tendency, 0.18, 0.19, 0.21 in the last test results, over the past 2 months.
In my recent consultation appointment with my Oncologist, the plan is that I do need to get SRT. At that time, he ordered a PET PSMA CT scan and leaned strongly about adding 6 months of ADT, regardless of the results of the scan. He explained that the scan would be just to define if the target is only the prostate bed, or anything beyond that also.
I just got my PET PSMA scan results and these came out perfectly clean. Nothing showed up, fortunately.
I have researched about the need or benefit of adding ADT in my particular case and it seems like I am right at the gray line, where it might or might not be of significant benefit.
I am 56, my Adverse Factors are : 3mm Positive surgical margin post-RALP (pattern 4), Gleason 4+3 (high proportion of pattern 4), Low tumor volume (5%), Early PSA rise (< 6 months); my Favorable Factors are: pT2 (no extracapsular extension), pN0 (clean lymph nodes), Negative PSMA PET. Side effects from RALP: zero incontinence, ED gradually recovering.
My big dilemma at this point is trying to ponder the tradeoff between possible added benefit vs side effects of ADT. ADT might not add any significant benefit in my case, but it might not be as bad as to not accept the marginal benefit that it could provide for me. On the other hand, the marginal added benefit might not be worth the possible side effects. Without being completely certain of making the right decision, I am leaning more towards avoiding it.
I have my next appointment with my Oncologist scheduled, where we will review my PET PSMA scan and define the final plan. I would greatly appreciate any comments and shared experiences regarding this big decision, that will help me be better prepared, with good supporting arguments, when discussing my treatment plan with my Specialist.
Thank you.
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@bikeman1
I am getting radiation for prostate cancer reoccurrence, I had a prostatectomy 3 years ago. They are including the lymph nodes with the prostate bed in the first part then doing additional to the prostate bed. I showed nothing on the psma test. They are giving 45 gray to the lymph node portion. I will complete this portion next Monday then will have 13 more sessions for prostate bed.
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3 Reactions@klein505
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What can I tell you ; ), win is a win ! lol
Sending you special hugsssssss 💖 Mrs. K : ))))
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2 Reactions@pamperme
You are so close to the end of your treatment - BOTH RT and ADT 👍🍀 ! Just a little bit longer ( 2 weeks) and than you will be able to relax and recover : ) .
I am wishing you 100% success 🍀 and may BCR never happen again !
Please stop by with updates about your recovery : )))
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3 ReactionsWhat a bunch of over achievers!! And I thought my Decipher score was so special 🙂
@pamperme: Good luck getting through the rest of the treatment and I hope you have a perfect PSA for many years to come!
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9 Reactions@bikeman1
Thank you. I wish everyone success with their cancer treatment and hope some day there will be medicine to eradicate
Wishing everyone happiness. My happiness is being with my grandchildren.
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5 Reactions@surftohealth88
I may have missed it, but did your husband get his PMSA PET scan results yet? I hope they were good news.
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1 Reaction@bikeman1
Aaawee, thanks so much for remembering and for checking on us 🥰💗 !!!
STILL waiting 😩 !
My daughter today asked me if they sent scans to SF hospital via Pony Express or what ? *sigh. It came to them Tuesday , now we wait for them to look into scans, hopefully ...
Anyways, needles to say, I have heart palpitations already due to this prolonged agony of waiting for results, by the time they post them I will be twitching like a bug that got a good whiff of "Raid " ...
I really hope that your doctors figured out what meds you can take without effecting your heart 🍀 !? Did you ask them about Nubeqa ? Maybe you can have that alone, instead of Orgovyx ?
We finally managed to schedule MRI - it is on June second. They would not have ordered it if we had not ask for it - I do not understand anything any more ...
Once again, thank you for stopping by ! *HUGSSSSS
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1 Reaction@surftohealth88
It is amazing how your husband and I are in such similar situations. I already had my MRI, but my PET scan is scheduled for........June 2!. So your husband and I will be getting scanned the same day! Luckily I have an appointment with my RO on 6/3 to review the results. Then I just need a "simulation" to get it all lined up and then I will finally start the SRT.
On the hormone therapy side, my cardiologist said it was fine to stop the heart drug that conflicted with Orgyvx. I sent that info to my MO, so I could start immediately on whatever drug she wanted, but there are a few hoops yet for that to happen. So....we are waiting, like you. Hang in there; sending positive vibes your way.
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2 Reactions@bikeman1
I started a new thread with PSMA results that just came in - I hope that your results will be much better then ours 🤞🍀.
We have some lymph nodes positive : ((((, but it is what it is .... *sigh
Fight continues.
I am so glad that you sorted out medications - yeayyyy ! Now you can start with first line of defense and very soon after the sRT will zap those PC cells to smithereens !
Sending you best wishes and healing vibes 🤗
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