Radiation after surgery

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CAMStL
CAMStL CSN Member Posts: 1 *

husband was officially diagnosed November 2024 Gleason 7 (3+4) after several increasing PSA numbers, MRI and biopsy. After PSMA Pet scan results, he decided to go for removal of the prostrate. His thinking was let’s just get this out and move on. Rough surgery, nearly 6 hours, but all pathology reports came back with clear margins. First PSA 8 weeks out from surgery came back at .3. Doctor not super concerned. Possibly a bounce back. Three months later, second PSA came back .4 and another Pet scan was ordered. Cancer has jumped to lymph notes in the abdomen. We meet with the oncologist on July 2. His urologist/surgeon thinks that we are looking at radiation. Can anyone help with questions we need to ask the oncologist?

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  • swl1956
    swl1956 CSN Member Posts: 246 Member

    I too had metastasis to pelvic lymph nodes 6 months after an ablation procedure. My oncology team then recommended 2 years of first and second generation ADT along with 40 IMRT treatments which I completed a couple months ago. So far this strategy has been successful. My PSA is now undetectable and I'm feeling fairly well with the exception of some minor urinary and bowel urgency which my doctors claim should improve with time. Your husband should ask about expected side effects from whichever form of RT they recommend and perhaps ask about ADT as well. Combination therapies are clinically proven to be more effective than single modalities however the ADT does have its own list of side effects. There will undoubtedly be sexual ramifications which you might want to discuss so you know what to expect. Sorry he's going through this stuff, but with good doctors there's much they can do.

  • Clevelandguy
    Clevelandguy CSN Member Posts: 1,336 Member
    edited July 2 #3

    Hi,

    Agree with the advice from swl1956. Radiation sounds like the best bet, talk with your doctor team to determine the best forum of external beam to use. Radiation usually has minimal short term side effects with more pronounced side effects later on. ADT is commonly used with radiation, also check with your doctor team on possible side effects. ADT can cause very uncomfortable side effects. Radiation is the kill mechanism, ADT will not kill the cancer but weaken it with the Radiation giving it the final blow. Looks like you’re about 6-12 past the surgery so your husband is still healing, watch that the radiation treatments don’t complicate his surgery recovery. A second opinion might be a good idea.

    Dave 3+4