Prostate Treatment Post Radiation BCR

neilm
neilm Member Posts: 73
in Prostate Cancer #1

I just wanted to share some knowledge should anyone out there have a PCA recurrence in the prostate after radiation. I am post Proton and listen in on topics with my local specialists who are involved in various research. I heard from a Brachytherapist who is engaged in level 2 trials on what sounds like a terrific salvage treatment. The basic idea is that radiation beam therapy is generally effective but when it leaves something behind it is generally a singular lesion , a master lesion if you will. Focal therapy in theory is much better in this environment because the likely singular remaining tumor can easily be identified ( not the same in primary focal therapy). The doc places radioactive particles following a live map which includes the radiation field forecast ( which are small fields for each particle ) and shape it around the tumor. Rectum and urethra can be spared in most cases. This is new but the data I saw was excellent two years out in ( 29 out of 30) patients with side effects which is a big deal on second time around with radiation and on cure. If you find yourself in a situation where you are dealing with a contained BCR it would be worth discussion and might avoid a difficult prostatectomy or long term ADT, the mapping tools for Brachy sound amazing. This was University of Washington , Fred Hutch Cancer Research Center. If I have a reoccurrence I would check this out.

Comments

  • jc5549
    jc5549 CSN Member Posts: 82 Member
    #2

    I would tell a cautionary tale of more radiation to the prostate after an initial full course of therapy regardless of the modality (I.e. proton, ciberknife, IMRT, SBRT). They all tend to dose the pelvis and prostate with maximum rads to achieve cure. More brachy, even if it is focal which does not make sense in PSA failure after initial full treatment, would concern me that you will end up with complications that are very difficult to treat. Radiation Oncologists NEVER treat the complications of their interventions, surgeons do.
    I urge you to get multiple opinions, including urologists, before pulling the trigger. Level II or phase II trials are still testing safety and efficacy of an intervention.
    Only phase iii trials are truly designed to demonstrate superiority or equality of the new idea when compared to current treatment protocols, in this case salvage prostatectomy.
    I would be very careful before jumping on board a new intervention that is only in phase ii of proof of concept.
    Good luck to you my friend

    jc

  • neilm
    neilm Member Posts: 73
    #3

    Thanks JC for keeping my notes in balance. You are correct this is early in development but I think it is worth watching. This concept makes sense to me but as you said it is very early. I too have discovered how to make an oncologist vanish, have him treat you. This concerns me in many organizations they ( RO’s ) may have no certainty for how often their treatments fail. I am not signing up for this but think it has potential, time will tell, if late effects start developing beyond 2 years then this may all fall apart. For anyone reading this thread please get multiple opinions from qualified professionals before signing up for anything!

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