I really don't understand the question. Radiation keeps the tumor from growing by preventing the PC cells from dividing. It destroys their DNA. If the cells can't divide they can't escape. If they have escaped before treatment has started then radiation won't work. A lot of normal prostate cells will also die, but they are more resistant to radiation and if damaged are able to repair themselves, so there will always be some live prostate cells still in the gland that will continue to thrive. Some tisssue like the ureatha are highly resistant to radiation and are not affected as much by the radiation.
In some cases if you don't get an experienced doctor the seeds are not evenly distributed throughout the prostate or margin and some dead spots may occurr. In these dead spots PC cells can continue to live. It is therefor important to get a CT scan two weeks after the procedure as a Qualty control to make sure the seed distribution covers the entire prostate and the desired margin. If dead spots are identified more seeds can be placed in these spots.
In 18 to 36 months a PSA bump can occur. This is caused by the last dieing cells releasing their psa, almost like a last gasp.
64 years old.
PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.
2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.
Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.
Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.
25 treatments of IMRT 6 weeks after seed implants. No side affects at all.
PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.