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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...
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.
