My father is 75 years old. He is a patient of prostate cancer. His gleason's score is 8. His PSA is 22.6. CT scan reveals that 2 iliac nodes & left seminal vesicle are involved. No bone metastasis on bone scan. It is T3 N2 M0. He has taken his first zoladex injection (3 months implant)10.8 mg S/C 3 weeks back. He is also taking casodex three times a day since 5 weeks. Oncologist has advised radical radiotherapy to be started immediately. When I consulted another oncologist, he advised to start radiation therapy 3 months after the 1st dose of zoladex. According to Radiotherapist, radiation should be started 2 months after starting zoladex and 2nd injection of zoladex should fall during radiation period. I want to know 1) when to start the radiotherapy after starting the 1st dose of zoladex? (as there are three opinions).2) Why radiotherapist advised to take 2nd injection of zoladex during radiation period? Does the hormone act as an adjuvant? Do Hormone & radiation have synergistic effect? Please help me in this matter. Thank you....Sita
There is no clear cut protocol for hormonal therapy with radiotherapy in prostate cancer. Radiotherapy can be initiated before, during or after radiotherapy. The preference of either may vary with the stage, risk factors etc. With the clinical description mentioned, I would prefer to go with the oncologist, rather than delaying radiotherapy.
Hope this is helpful.
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