Radiation after surgery & Prostascint

ezra99 said:

Question & comment
Hi,

Thanks for the information. I have seen two urologist and one medical oncologist. All three want me to talk to radiation oncologist. I did discuss with them the 2007 EORTC 22911 study that says that radiation is only 12% effective for post-surgicals with negative margins. They still claim that I have an 80% chance that cancer is in pelvic area and could respond to radiation. I'm not sure I understand it. Maybe it is because of my stage? I plan to discuss in more detail with radiation oncologist. It was suggested that I may want to have the Prostascint prior to my decision to start radiation. It was recommended that I talk further with rad doctor about that. I'm having difficulty finding more information on Prostascint but have found some. It sounds as if it may be as high as 70-72% accurate at finding cancer cell location. Do you (or anyone else) have any sources or experience with ProstaScint scans? Also, do you know of any other studies that validate EORTC 22911 study?

Thanks

Kongo said:

Nana
A prostascint scan looks to pinpoint cancer in areas like the lymph nodes, seminal vesicules and so forth. Like you described, prostascint is a two step process where first they inject a nuclear marker (a radioactive isotope with a very, very short half life) than will attach itself to any cancer cells. About four days after the radioactive marker is injected, they will do the scan where the isotope attached to the cancer cells can be easily detected. I am sure they probably also did a blood test which will look for potential cancer in the liver. A chest x-ray will look for tumors in the lungs. The bone scan looks for cancer hot spots in the bones and it also uses a radioactive market. These are all places where prostate cancer spreads when it leaves the prostate. Since your husband had his prostate removed four years ago, the residual PSA is an indication that there is still some cancer somewhere in his body and pinpointing its location is necessary before they determine which treatment might be necessary.

The good news is that your husband's PSA seems to have remained very low since his surgery. This could well be an indication that the PCa in other parts of his body is the slow growing, indolent variety which may not pose any serious long term threat to his health.

I suspect your urologist was trying not to upset your husband when he characterized it as "a little" bit of radiation. Typically, radiation treatments after radical prostectomies use a process called IMRT that takes about 45 sessions.

Your doctor may consider some form of hormone therapy in conjunction with radiation. It all depends on what the tests show.

On the other hand, if the tests don't show much cancer outside of the prostate bed and your husband's PSA readings remain low, maybe you don't need to do anything at all except monitor the PSAs. Depending on your husband's age, general health, and other factors you may decide that the potential impact on his quality of life does not warrant additional treatments, particularly if the PSA remains low and there are no other cancer symptoms.

Whatever the tests show, I hope you get some second opinions.

Hope all of this works out well for you and keep us posted.