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Medical Forum / Diseases and Disorders / Prostate Cancer / May 2007SALVAGE RT POLL 2
I am resurrecting this old thread* to see if how guys having SRT in the last 3 years have fared. Please chime in. Those who have followed my case know that I concluded not long after the initial post that I probably had systemic disease and would not undergo SRT. I have seen several doctors in the interim and none have been able to disagree on the stats. On 4/23 I flew from Memphis to Boston and saw a med-onc at Dana Farber who had been recommended by a Pt friend of my brother. Despite my last PSA of 1.6, SVI, Partin II probability of local-only recurrence of <6%, and pre-op PSA of 33, he recommended SRT. Not because it had any great chance of success, mind you, but because "it's the only chance for cure." He does not use the Partin II calculation but cited 2 studies that showed as much as a 20% chance. I haven't really parsed those yet but I suspect that my numbers would put me in the lower range w/i the group I would fall into. My suspicion is that SRT is not very effective in high risk cases. Bill Denton RP 2/12/02 PSA 1.6+ Memphis On Feb 27 2004, 10:26 am, zeros...@midsouth.rr.com (Bill Denton) wrote: "Has anyone in this NG heard of anyone w/ seminal vesicle involvement or other high-risk pathology whose recurrent PCa was "cured" by salvage RT? I am at that point and my uro says RT won't help and the rad-onc says to have it (in his financial interest, of course). Walsh and all the stats I've seen say no." http://groups.google.com/group/alt.support.cancer.prostate/search?group=alt.supp ort.cancer.prostate&q=salvage+rt+poll&qt_g=Search+this+group * I tried to post on the old thread but it would not let me. ?? > he > recommended SRT. Not because it had any great chance of success, mind > you, but because "it's the only chance for cure." I just can't respect that rationale in general. It implies that physical, fiscal, and logistical treatment costs are moot, that even voodoo or snake oil are valid by the same reasoning, and that nothing is more important than how long we draw breath. Sure, his rationale and recommendation may happen to be valid in your particular case, but that doesn't validate the overall paradigm. I'd want to dig a few layers deeper into the issue, seeking better definition of SRT's therapeutic index *in your case*. All he's openly considering is the nominator of that ratio of benefits to threats. And how exhaustively have you been tested for mets with the latest whiz-bang procedures? My first grasp at straws when my PC returns will be in testing, not treating. I.P. >I am resurrecting this old thread* to see if how guys having SRT in > the last 3 years have fared. Please chime in. I think you know, but will recount anyway. If'n you're asking how I handled the radiation; it was a breeze. I walked a lot, drank a lot of water, and slept longer and my SEs were very greatly reduced. If'n you're asking about its success, I was radiated May to July 2002.... oh, my! I just realized that it was more than 3 years ago. Where has the time gone? Well, I'm finishing anyway. Within a year, I was on Lupron. It was apparently successful at eliminating cancerous cells on the prostate bed, else I would not have had three consecutive reductions in PSA. However, it was nothing more than a speed bump to my cancer.  SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 PSAD .056 years Lupron 07/03 (1 mo) 8/03 and every 4 months there after PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years Casodex added daily 07/06 PSA <0.04, <0.05 Non Illegitimi Carborundum After having PSA at undetetable levels for 5 years after RP in 1995, my PSA started rising and I had external beam radiation to the region of the pelvic floor in 2000. After that, PSA was again undetectable for another 5 years and started rising in 2005. I'm now on Casodex. As I've offered to others in this group, I feel that the radiation "bought" me 5 years. I'm sorry the PSA is back and the side effects from Casodex (any ADT, I think) are no fun. But, I'm here and I'm having fun living. I hope this helps. Good luck! Please keep the group posted. Burney >I am resurrecting this old thread* to see if how guys having SRT in >the last 3 years have fared. Please chime in. [quoted text clipped - 30 lines] > >* I tried to post on the old thread but it would not let me. ?? Had a positive margin after RP and a psa of 0.3 - 90 days after my surgery. Going on four years after salvage with last psa 0.01 six months ago. It was <0.01 for over 3 years. Rad/Oncologist says the last test was faulty and he wouldnt be concerned and would be the next test would be <0.01 My surgeon says the same thing but warned of an increase. My test is next week. I just read a new research paper on pubmed that states whole pelvic salvage readiation is far superior to regular salvage radiation. I have posted the link below. If you cant reach it go to pubmed. The title is called. "Radiotherapy After Prostatectomy: Improved Biochemical Relapse-Free Survival with Whole Pelvic Compared with Prostate Bed Only for High-Risk Patients." http://www.ncbi.nlm.nih.gov/entrez/query.fcgidb=pubmed&cmd=Retrieve&dopt=Abstrac tPlus&list_uids=17459606&query_hl=2&itool=pubmed_docsum On 11 May 2007, you wrote in alt.support.cancer.prostate: > Had a positive margin after RP and a psa of 0.3 - 90 days after my > surgery. [quoted text clipped - 8 lines] > > My test is next week. I wish you well on your test Dave :) I had the prostate bed done (36 EBRT) in 06 after RRP in Dec 05. Right now seems to be doing okay for me although I added Lupron as well. 2 PSA's are a good sign so far - lupron SE's suck! Life is good otherwise! Russ >I am resurrecting this old thread* to see if how guys having SRT in >the last 3 years have fared. Please chime in. [quoted text clipped - 30 lines] > >* I tried to post on the old thread but it would not let me. ?? From 1995 to 1999 my PSA went from 9.2 to 18.5. In this period I had five negative biopsiesÂ… I had RRP in March 1999 when the sixth biopsy finally found 1 core positive. From the pat report: Extra-capsular extension: negative Lymph node involvement: negative Seminal vesicle involvement: negative Perineural invasion: negative Surgical margins: negative PSA was <0.04 until March 2001. Salvage RT in March / May 2005 when PSA had reached 0.2. PSA is currently <0.02. Next test in October. Good luck to all. Just Best of everything to YOU, Just. Ron B. Chicago |
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