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Re: Difference between salvage and primary radiation treatment.
Bruce,
With primary radiation treatment the target is the prostate, plus sometimes the seminal vesicles and maybe a bit beyond. To state the blindingly obvious, when the prostate is no longer there the target is more widespread. They're aiming for the surrounding bits - of variable shape and depth - where the cancer may have spread. The trick is to get the dosage right. This means a wider spread of radiation at the right killer dosage to tissues that are not tightly packed around a prostate gland any more. So the dosage and conformation of the radiation has to be quite different. My guess, as a former physicist - a long, long time ago - is that it is harder to get this right than with primary treatment and I suspect that side effects are more likely to be an issue, remembering that lower dose radiation can cause bladder and colon cancer.
I can see how salvage surgery after radiation works but I do worry about how successful the reverse might be, given the difficulties. Perhaps someone on this site knows the success rates?
Re: Difference between salvage and primary radiation treatment.
David,
It was explained to me that with salvage they don't try to be very precise because they don't know exactly where they need to hit. With primary a precise radiation machine is more useful since they know exactly what they are aiming for, assuming you or your bladder don't move during the 30 seconds or so that they are radiating you.
