[From my blog, so bear with me]

The American Society of Clinical Oncology recently held their annual
conference . . .

The following article touts the benefits of *adjuvant radiation
therapy,* after RP, *even for higher-risk patients*:  It is called:
High-Risk Disease After Radical Retropublic Prostatectomy: The Case
for Adjuvant External Beam Radiation Therapy.

First of all, let me explain some terms.  "Adjuvant Radiation" is
radiation therapy (RT) given after surgery but before there has been
any noticeable rise in the patient's PSA level.   It is essentially a
prophylactic measure.  "Salvage Radiation," on the other hand, is
administered after the patient's PSA has begun to rise.

I posted an article some time ago urging patients to explore the
potential benefits of adding radiation to surgery (see "Consider
Adding Rad to Surgery"), and this new report underscores my point.  It
goes so far as to say that even for high-risk cases, adjuvant
radiation (XRT) may confer a significant benefit.  Last time I
investigated this, I kept on reading about XRT being "underutilized,"
in spite of its proven value.  Well, this needs to change.

It had been thought that radiation after surgery would only work if
the cancer were truly localized.  That is to say, if the patient's PSA
starts to rise post RP, RT would work only if the remaining cancer was
confined to the prostate bed (fossa), usually indicated by a positive
margin.  Now they are thinking that even people whose cancer has
spread beyond the fossa may benefit from XRT.  Also, they underscore
the point that some high-grade cancer, or metastasis, may result from
*localized* residual prostate cancer that has entered the system.  In
other words, metastatic cancer is not always qualitatively different
from localized cancer.

Everybody agrees on one thing:  if you are going to have post-RP rad,
do it yesterday!   Don't wait.

I strongly suggest that if you have intermediate- (Gleason 7) or
higher-grade cancer, talk to a radiation oncologist about the
possibility of adding adjuvant or salvage radiotherapy.  Adjuvant is
preferable.  The sooner the better.  Remember, your surgeon may not
suggest this, so you have to be proactive.

What is the downside of adding rad immediately after surgery?  The rad
itself is painless, although it may be inconvenient to go for 40-or-so
brief sessions.  My husband had salvage rad six months ago, and so
far, he hasn't had a single symptom.  But these may develop over
time.  Overall, RT is a kind and gentle treatment compared to what's
out there, and if you can increase your chances of survival by giving
the PC a 1-2 punch, I would go for it.

Then I would sit back in my La-Z-Boy knowing I did everything possible
to keep the cancer at bay.   Make believe it's the Showtime
Rotisserie:

Just set it and forget it.

Anyway, here is the article I've been referencing (I've highlighted
some items):

-------------------------------------------------------------------------

High-Risk Disease After Radical Retropublic Prostatectomy: The Case
for Adjuvant External Beam Radiation Therapy

Saturday, 16 February 2008

Excerpts:

**The risk of PSA failure was about half in the*adjuvant* XRT group.

**Freedom from clinical failure was 15% better with adjuvant
therapy.**

*The cumulative incidence of late morbidity [side effects] was small*,
with erectile dysfunction being one aspect that was worse.*

**The 10 year biochemical disease free survival was 47% and 23%
respectively for adjuvant and salvage groups.**

**The onus in on the uro-oncologist to discuss these data with the
patient with an adverse pathology report.**

------------------------
Leah

prostatecancerblog.net

"Behind every successful man is a woman who does the research."