What kind of radiation you had for salvage ?

Im not an expert, so take these comments as such.

Post-prostatectomy salvage radiation is not the quite the same as initial prostate radiation. Typically, salvage is radiating the entire pelvic bed and the lymph nodes. Its a much larger area. Precision is still critically important, as you are getting very close to the bladder and the rectum. But it is my understanding there are no gold markers like there are when radiating the prostate. All the fun side effects apply. Often, hormones are included as part of salvage if you are high risk.

The arguments for type of radiation are the same. Photon-based IMRT is precise, IGRT complements IMRT by adding targeting precision that incorporates body movement and breathing. Proton is also an option. Proton offers the same benefit as it does for initial prostate radiation - in theory, anyway - using precise pencil-beam radiation that only "activates" when it reaches the target areas, and does not impact the areas going in or coming out. However, recent studies have indicated that proton is no more effective than photon.

Keep in mind that you will have 25-39 treatments, 5 days a week, so proximity is another factor to consider.

Ultimately, those decisions are up to you and your RO. There is lots of info online on salvage.......

@xahnegrey40 Today I am on 12 of 38 IMRT sessions hitting a local recurrence (palpable nodule) and the pelvic lymph nodes (prophylactic). No pelvic pain, but some occasional tingling and a feeling like I just applied icy/hot to the area. I guess that might be viewed as a very low level pain. I reported this to my RO yesterday, and she didn’t note it as anything out of the ordinary. Also, am feeling some fatigue and loose bowel movements, but am holding up pretty well overall. Hope your side effects don’t get any worse.

@mlabus3

Thanks so much for detailed information and advice 👍💗.
Yes , for us proximity will be a major factor to consider since my husband still works full time and also distance involves extra expense. BUT, it is good to have all of the information and than make a decision taking everything into account.

@melvinw pretty much what I have--cant really call it pain..just feels like a slightly pulled pelvic muscle maybe..transient 0-2 pain level..tender ..met with RO this morning..he said no big deal.. the " radiation is hitting the pelvic lymph nodes...which is what we want.."..he said I was right on track..go enjoy weekend.

Yup, just finished #12. It’s the weekend!

I am currently undergoing salvage IMRT (12 down, 26 to go). I’ll note something here that my medical team underplayed before starting RT—the importance of having an empty bowel, which includes both stool and gas. All I was told was to try to have a bowel movement each day before treatment. There’s more to it than that. I had to adjust my diet (largely vegan/whole grains with lots of insoluble fiber) to reduce gas. I made the adjustment, and things are going smoothly now, but I would have liked to have a running start at this. And that included for the initial CT planning scan. If your bowel is not empty, then things can shift around and the rectum and intestines can get hit with radiation and cause diarrhea, proctitis and such. You might even get kicked off the table for that day, which just adds an extra day at the end of the run. I’ve attached a document from the Veteran’s Administration that provides dietary guidance for men undergoing RT for prostate caner. It found it very helpful.

@melvinw I had similar especially fatigue and loose bowels with a few flecks of blood. The struggle got real near the end for bowels, bladder urgency and fatigue. At some point after radiation, almost complete loss of bowel control for a couple a few weeks. It quieted down then reappeared 6 months later and at almost 8 months post finally quieting down again. Radiation seems to be the gift that keeps on giving for a period of time. RO didn't do a thing for me. Fired him after finishing ADT. Wanted me in for blood work 2 DAYS after ADT for blood work. I had blood work at 3 months so knew it was working. Nothing but a money grab. I am doing 3 month blood work post treatment and they also want me to come in to give me my results, generating another billable event for them. Money grab.

@jeffmarc Hello Jeff - sometimes these posts confuse me. Contributor "surfohealth" asked for help/advice on types of radiation, etc. Your two separate responses seem to convey that you know that he has "not" had a radical prostatectomy, yet I assumed that he had because he refers to "salvage" radiation. Everything I have read about "salvage" radiation is about and for men who have had the radical prostatectomy, and have seen their cancer return...so now it is time for the next phase of treatment: "salvage radiation." Your answers are both good, but I wonder if "surfohealth" has had the radical prostatectomy or not? I have posed the question directly to him. What were your thoughts/assumptions on this when you offered your answers?

"Surfohealth" - I am confused a bit: Have you had the radical prostatectomy surgery? You refer to "salvage" radiation, which is a term usually used in conjunction with "post-radical prostatectomy" patients who have seen their cancer return at some point years later. But I also know that some men elect not to have the radical prostatectomy, but rather go straight to radiation therapy to try to kill the cancer. What did you do? I myself am a post-radical prostatectomy patient (6 months ago), and I have been told that my pT3b cancer has a very high likelihood of recurring "within five years." At that point we would talk about, and likely start 40 straight days of "salvage" radiation. Thanks for reply and clarity in advance.

@rlpostrp
Actually, I have been in multiple discussions with @surftohealth88 I am aware of the fact that her husband has had a prostatectomy.

She is interested in getting adjuvant radiation rather than waiting for the PSA to rise and getting salvage radiation. You may see some discussions about that because she has been trying to find out if anybody else has been doing it.