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Adjuvant Radiation

mjweis
Posts: 11
Joined: Jan 2009

Had RALP surgery on April 2 & have no complaints regarding my recovery. My issue is that mine was a small tumor in a 'not so great' location and the doctor is recommending that I consider adjuvant radiation.

Some of my post-op pathology results:

Staging: T2aNXMX
Perineural Invasion: Yes
Surgical Margins: Carcinoma involves left apex margin
% of prostate involved: <5%.
Pre-op PSA: 2.7
Post-op PSA: <0.1 @ 4 months

I am looking for help in the decision making process - candidate selection criteria, info on treatment, side effects and success rates would be very helpful.

lewvino's picture
lewvino
Posts: 1004
Joined: May 2009

Sorry to hear that you had a postive margin. You might want to post your question over at
http://www.healingwell.com/ in their prostate blog. They have a very active group and you will probably find someone that has been down the same road. The CapnLarry on this forum told me about the other forum.

Good luck and keep us updated.

Larry

tarhoosier
Posts: 181
Joined: Aug 2006

MJ:

You did not add the most important variable, your Gleason score from pathology at surgery. If the G score is 3+3 or lower then surveillance is likely appropriate. If there is any G4 or G5 then less likely or definitely not surveillance. Your age is also a relevant variable. Your recovery of continence is also necessary to consider radiation. The Journal of the American Medical Assoc. (JAMA) has published the results of clinical trial SWOG 8794 and it is free to read and download. It was about men who may be like you-post surgery with + margins, though other characteristics are quite important. A serious consultation with a radiation oncologist and perhaps a medical oncologist who specializes in prostate cancer, if one can be found, would be necessary before deciding on treatment.

mjweis
Posts: 11
Joined: Jan 2009

Age at surgery: 44
Gleason (biopsy): 4 + 3 = 7
Gleason (post-op): 3 + 4 = 7

segersales's picture
segersales
Posts: 11
Joined: Jul 2009

i had 38 radiation treatments at scripps in la jolla, ca 2 years after surgery. I had tested zero for PSA and then we found a recurrance. Just had my PSA taken and it is <0.01 which is good.No side efects except I got tired the final 3 weeks of treatment. I feel fine now

Lindorf
Posts: 11
Joined: Apr 2009

I had an open RRP in May. Post op path 4+3 with tertiary of 5. 1 Focally positive margin T3a. PSA before surgery 24. So my pathology is more adverse than yours. There are several nomo tables that describe statistics for outcome that may be useful. What I found is that there is good support for Radiation Therapy either as adjuvant or salvage treatment. I am opting for adjuvant as there is a strong statistical advantage for adjuvant in my situation. There is also much support for hormone therapy with the RT. I am electing not to do that. As with much of what we face, there is not a single well supported answer for what to do. I agree that meeting with a radiation oncologist(or 2) is an excellent idea. I strongly suggest a medical oncologist as well as they may well have a different perspective.

Best Luck.

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