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My father was diagnosed with prostate cancer at the age of 71, with a PSA of 6.8, stage T2a-b, Gleason score of 3+3=6, 70+% prostate involvement (from 40% to 5%), and chose Image Guided (IGRT) Radiation as his primary/only treatment of choice at this time. Normally, they treat with 42 individual treatments. Because my father is doing well with these treatments (only urgency/frequency since about treatment 15-20 and no bowel impact, and moderate fatigue starting with the 30th treatment) they are considering doing a 43rd treatment.
My question is are there any pros/cons to adding one additional treatment on the end (I *think* they do 180 gray scale- sp? - units per treatment... for a total of 7560 normally and 7740 total if they do this additional treatment). It's not the "standard", but they think he can tolerate this treatment (and as I compared the radiation dose to the Proton Beam therapy when we were 1st discussing, they mentioned they could add on a treatment at the end to get similar grey scale (sp?) levels of the Proton Treatment if my dad tolerated things well).
Any advice of pros/cons/experience you could offer would be appreciated.
I have only a small related experience to offer, but I think this is a very interesting question. It seems so natural yet seldom is discussed. I had only a 60Gy adjuvant radiation plan (after surgery) and I also had minimal issues with it and I asked my radiation oncologist if maybe I should do another day. He didn't want to even consider it. Later I figured out why, due to my disease specifics. He said it's purely a question of numbers. In my case a 60Gy treatment should eliminate entirely a 1cm diameter tumor with 90%+ probability. As long as it is located in the radiation field area. Maybe this sort of thinking goes into how your docs are handling your dad's situation, I don't know. I hope others here will have something more helpful to offer. Seems important to understand this issue.
Beth:
The previous poster has good information for you. Certainly, each man has a different case and anecdotal information is worth less than the scientific opinion of his doctors. Generally, higher radiation can provide better rates of success, but at the risk of higher side effects. If the doctors in the case of your father are "recommending" more radiation, then one must assume that they wish to do so, and have assessed his side effects so far and consider it reasonable to continue. Side effects often accumulate for an extended period after radiation is complete, so performance now may not be a true indicator of SE in the future. Your father appears to have significant involvement in his prostate with 70% cores positive (if I read that correct) so perhaps this is what the radiologist is concerned about. A frank discussion with his care team of the potential benefits and risks is the only answer to the situation.
