The next "Step" after robotic prostatectomy

Clevelandguy

https://csn.cancer.org/discussion/comment/1725909#Comment_1725909

Hi Ric,

Radiation is usually the next step after your prostate removal along with some form of ADT. I would look into some of the newer ADT drugs that are supposed to have fewer side effects. The ADT effects on person vary from tolerable to nasty, no set answer. I would go with the milder ADT drugs 1st, and save the nasty ones for later if the milder ones don’t do the job. PMSA PET scan is a good thing but sometimes it can’t find the very small metastasis even though your PSA has increased so don’t be too surprised if the scan comes up clean. If the PET scan comes back clean then what area will they radiate? Usually doctors don’t take action until the PSA has reached .2+ level. A second opinion from a different doctor(s) and hospital network might not be a bad idea.

Dave 3+4

rick2026

https://csn.cancer.org/discussion/comment/1726026#Comment_1726026

thank you for that information

I’m Not looking forward to any drugs with radiation either. The oncologist did mention hormone therapy accompanied with radiation.

my PSA is 0.12 as test tested in December. February 20 is my next PSA test.
March 2025 my PSA was 0.05 so between March and December it went up 100 of a point each month. The thing is you’re right the might not find or see cancer . They are assuming PSA detection or cancer cells in the American Cancer Society states that is not a definite for sure thing. Sometimes PSA can linger, but that doesn’t mean they’re cancer.

Thank you for your insight and your information. Rick

Josephg

I respectfully disagree with @Clevelandguy on the ADT treatment protocol discussion of going with milder ADT drugs first, and then possibly others later. To my knowledge, the current ADT treatment protocol theory is to hit the PCa cells HARD with a combination of ADT drugs, because it has proven to achieve a much higher weakening/kill rate than single ADT drugs, one at a time, and overall better outcomes.

I am not a medical professional, so my words are my opinion, based upon what I've experienced in my own ADT treatments, and what my Medical Oncologist tells me about the outcomes of different ADT treatment protocols around the world, which they track closely, and which are delivering the best outcomes to patients.

@rick2026 , I would suggest to you to discuss this in depth with your Oncologist, and of course, to continue your own research on the topic.

rick2026

https://csn.cancer.org/discussion/comment/1726030#Comment_1726030

noted and thank you for your input and concerns . It’s an interesting post. I hope I can remember to discuss this with my provider.

my initial consultation two weeks ago didn’t go too well. I drove all the way to Loma Linda, which is about a 40 minute drive with no traffic only to talk to him on a phone there because he had a cold. Very impersonal. He could’ve called me and told me he was sick? Maybe we could’ve rescheduled for a face-to-face confrontation instead of on a call? (Is this a bad omen? )

Clevelandguy

Hi,

I would check with your doctors but from I have read drugs like Orgovyx(newer) have less side effects than more traditional drugs like Lupron while just as effective as reducing your testosterone. Lots of info online about the newer vs the older ADT drugs, good luck.

Dave 3+4

rick2026

https://csn.cancer.org/discussion/comment/1708135#Comment_1708135

hi Eric please tell me how you dealt with the hormone therapy and radiation? Were you able to continue with your normal lifestyle post? I have minor dribbling and light incontinence that I can manage mostly at night worried it’s gonna affect it more or bring it back the way it was after robotic.? I’m also concerned that I won’t be able to maintain my current getting back to healthy lifestyle routine? I think you can add would be interesting to know thank you so much.