Prostate Cancer Survivors






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Re: wide or narrow radiation?


I have done a great deal of reading on this issue.

Early studies showed "whole pelvic" radiation confered no significant benefit.
Therefore there are some doctors that do not subscribe to it.
However, those studies are now considered to be flawed.

There was a more recent study, I believe it was done by a Dr Roach et al.
RTOG 9413? maybe... can't remember.

The Roach study seems to be generally accepted by radiation oncologists as the basis for current treatment guidelines.

It had patients in four different groups to evaluate Prostate only vs Whole Pelvic and also neoadjuvant hormone therapy vs. adjuvant hormone therapy.

The group that did the best was the whole pelvic with HT prior to and concurrent with radiation.
I can't remember the end points, whether it was biological disease free survival or overall survival but the benefit was about 20%.

I just finished my course of IMRT treatments with 25 whole pelvic sessions and 20 prostate only for a total of 81Gy.
The side effects were quite tolerable and are fast clearing 2 weeks post-treatment.


Re: wide or narrow radiation?

Hi Tony,

Thanks for your detailed explanation.

Just looked at the Roach study and some comments on it- I think I can see both sides of the issue pretty well- it just bothers me that I need to make the decision...

Good to hear that the radiation is behind you- may you continue to feel good results!

Is the 81 GY dose you mentioned experimental, or is it standard? Seems to me I heard numbers closer to 75 here...


Re: wide or narrow radiation?

Bear in mind that whole pelvic radiation is generally reserved for patients that are locally advanced and considered high risk. If there is any reason to believe that the cancer may have migrated to the lymph nodes, then whole pelvic is in order.
In my case, even though there was no concrete evidence, I had some slightly enlarged pelvic nodes and a very high PSA.
That was enough justification in the mind of my doctor.
As to the dose, in radiotherapy it is known that the higher the dose, the better the response.
81Gy may not be necessary in all cases but I had a high volume tumor.
My doctors shrank it with HT and blasted it.
I had a lot of trepidation about the "whole pelvic" and the high dosage because I thought it would make it harder to avoid collateral damage to the bowels and bladder. It seems my fears were unfounded as I had no real problems during the treatment. I am now 15 days post-treatment. Unless some toxicity shows up later, I would say that I tolerated it very well.
The radiation oncologist and his team did a fabulous job.

Now I simply sit back and pray it was successful.

Re: wide or narrow radiation?


Good to hear from someone with similar experience.

Guess we will just have to wait and pray together...