Can you have salvage surgery after failed radiation? The technical answer is yes, but it would be all but impossible to find a reputable surgeon that would do it. My own surgeon with 30 years experience said he only saw two done, when he was in medical school, and they so screwed up the lives of the patient, and it was the most brutal surgery he had ever seen even to this day. After radiation scrambles ,melts, disfigures the prostate bed, there isn't much in the way of any clear margins, edges, or boundaries for a surgeon to operate. Even if you get through the surgery, the failure rate for ridding any PC reaccurance is very high.
This is why it is so important to choose your primary treatment well. If you are low gleason, low PSA, low staging ,low % of cancer in any biopsy cores, there are non-surgerical methods that should be effective and safe. But if any of the above are on the high side, surgery would make more sense for most people.
You have to remember, you don't get a second chance on the primary treatment, and you need it to erradicate the PC completely if possible, and if not, at least give you a shot at a second attempt for a cure.
David in SC
56, 56 at DX, PSA
7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes
First PSA Post Surgery 2/9 .05, 5/9 .10, 6/9 .11, July 13 - meet with radiation oncologist