Prostate Cancer Survivors






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Re: Radiation Treatments Started

I went through salvage radiation 6 months ago. For me it was smooth sailing through out the process. I was very active although I did take a short nap almost every afternoon. I drove one hour each way so my fatigue my be to my early morning drive. I hope your radiation treatment works out as well as mine did. One difference with me is I had 6 months of ADT. I am still dealing with some of those side effects. I go next week for a PSA and I hope it is undetectable. I do not want to be on ADT for an extended period of time. Why did you get salvage radiation if your PSA was undetectable?

Re: Radiation Treatments Started

Both my surgeon and RO were very surprised and concerned that what was thought to be low grade/low involvement, contained cancer turned out to be a higher grade, 50% involved, with multiple positive margins and ECE/bladder neck. The non-focal aspect was also a concern. I am only 57 and with how many cancer had changed rather quickly , my RO felt the risk of recurrence was at the higher end of range of what the tables indicated (at values noted in the first part of the thread). We discussed the option of waiting until the PSA is detectable versus doing the RT while the cells are likely still in the prostate bed. As I read through what happened to most patients in similar circumstances, it seemed many went to RT/ADT combo following PSA rise at about the 2 year mark. So I opted for the more aggressive "do it now" decision. I think BillG stated it well in his reply when he termed it timely adjuvant rather than salvage.

Some related posting info from the which Terry so kindly referred me to:
Several studies recently have found a big advantage to adjuvant radiation (now) over salvage radiation (waiting for PSA to rise). Several studies have showed significant improvement in PSA progression-free survival with adjuvant radiation:

It also seems to be important to get enough radiation: 70 Gy seems to work significantly better than 60 Gy: