salvage therapy

Two and a half years post op .

PSA has risen from 0.04 to 0.15 . Surgeon referred me to Consultant radiotherapist .

She told me about 2 months hormone therapy , before 4 weeks radiotherapy followed by another 2 years hormone therapy . 

She also explained side effects , which didnt sound too inviting .

What I'd like some feedback on is at what point on the PSA scale people decided to plump for it and how they managed the side effects .

Although 70 I'm still playing footy , going to the gym and generally have an active lifestyle and at the moment cant make my mind up .

Any responses would be greatly appreciated .

Hi Alan48, My PSA suddenly started increasing about a year post op rising from 0.3 on 1/9/16 to 0.7 by November. So by the time I saw an oncologist I was way above the 0.2 which is regarded by most as a recurrence. That said clearly something is going on so if I were you I’d be seriously considering the HT and the RT as it is very likely (though not guaranteed) that you have a local reccurence due to the slow rise in PSA and time since surgery. I had a gadolinium enhanced MRI and a choline F-18 PET scan showing I had recurrence in the prostate bed and a seminal vesicle remnant.

This allowed my salvage radiotherapy to be very carefully planned to hit those areas plus the whole of the prostate bed.

My oncologist was very seriously concerned I would suffer life changoing side effects with terrible bowel issues but after a planning scan the risks were shown to be well within the tolerances he worked with.

He was also concerned I had distant spread in the form of micro metastasis which scans couldn’t pick up.

I had three months of HT and am still on that until January 2019. 

We wont know whether the salvage radiotherapy has worked until the HT comes out of my system.

I have increased side effects now where I leak urine randomly but espec when tired. I don’t leak massive amounts but it is enough to be embarrassing. I am also fatigued and suffer hot flushes from the HT. 

I gave up work recently and although I can get very tired I am active and enjoying life.

It is a big decision and as Chris says QOL must be considered. The alternative is that you may eventually have to go on HT if the PSA keeps increasing.

Best wishes,

Ian

Thanks Ido , that gives me more food for thought . Good luck .

Had RP surgery 2014. PSA hit 0.2 late 2017.
Had 33 sessions of Salvage RT plus HT. Still on HT. More details in profile.

RT was no big deal apart from driving through snow drifts to get to the hospital in February and March.

Experienced general fatigue and a bit of diarrhoea but nothing really horrendous.

All very bearable and not a major issue. Worked right the way through with only the occasional day off because of tiredness.

HT again is no big deal. I have learnt to live with the usual side effects without too much trouble.

My wife is very understanding.

What is the alternative ?

A long and slow downward spiral with an unhappy ending.

Edited by member 09 Nov 2018 at 12:03  | Reason: Not specified

By the way Chris , this disease at 70 still feels really s..t and I really do feel for you but there is no way I'm going to be packing it all in just because of my age !

I know a guy who was diagnosed at 46 and can appreciate how he feels.

I am not bothered about the inability to have sex any more but I am truly scared s-itless about what the next 10 years has got in store for me if I make it that far.