Radiation for recurrent prostate cancer

[skyhag]

I would like to know if any of you could enlighten me on the effectiveness of external beam radiation for the return of PC three years following radical prostate surgery.  My husband enjoyed three years of undetected PSA following his laparoscopic surgery.  Over the past fifteen months, his PSA has doubled from 0.05 to 0.1  His urologist has referred him to a radiation oncologist to discuss external beam radiation as a treatment option and we will have that appointment on Thursday.  From what I am reading, this sounds a little aggressive considering the numbers.  On the other hand, I'm in a state of panic because we've been going through this "watch and wait" game for over a year now.  If anyone has had a similar experience, I would appreciate your thoughts about what we should expect in the next weeks.

[HeinrikMD]

Hi,

The difference from 0.01 to 0.5 may raise doubts in your mind as to how larger a difference this really makes. There is no clear guide as to what levels represent alarming amounts for this low level. What is known is that best outcomes are for those who had low or undetectable PSA after surgery and have a PSA less than 1. Both of these make your husband a good candidate.

What needs to be established is that the disease is still local, that it has not yet disseminated (with the bone primarily suspect as omegacat has written). Hence, the work-up would be to do imaging in order to determine this. The radiation would likely be recommended if all the scans show disease as likely to still be local.

[skyhag]

Sounds as if you've had your share of experience with this unfortunate disease.  Hopefully, the urologist has evaluated his situation and acted in plenty of time.  This urologist trained at Hopkins and continues to seek advice from Dr. Walsh and Dr. Partin.   I wish we were close enough to one of the majors but feel we've selected the best there is in our area.  Thank you for your response.

[omegacat]

Several men in my life have and are undergoing treatment for PC.  It can be a devastating disease and first signs of increased PSA should be acted on quickly, procrastination can be a huge mistake.  Your panic is telling you that you need to do something. I think the radiation oncologist is a good idea; the more information you can get the better.

If your husband's prostate was completely removed with surgery, and his PSA is elevating, you need to rule out spread and he should have his bones checked.

My brother is currently being treated at Sloan Kettering in NYC.  If you possibly can, go to a well-known cancer treatment center such as Mayo, Hopkins, Anderson or Sloan.  That way you have a team working with you that is current on treatment protocols and you don't have to go from specialist to specialist. However, if you cannot go such a center, make sure you have a doctor that you trust, then read and ask questions; both you and your husband need to be as informed and aggressive as possible to be to beat this.

All my best.