I had surgery in July 2009 and my PSA was up to 0.4 by March 2010 without me ever having joined the zero club. I am thus currently having RT (Just had 19 of 33 sessions, with beams from 7 angles). I expect someone who is having RT three years or so on from surgery will be able to help you more.
With RT some docs will want to use Hormone Therapy at the same time; this is said to be more effective (my doc is not giving HT at the same time though)
RT and HT both have side effects, and there are the short term and long term ones.
I don't have to worry about
HT just yet, but I've been looking in to it. HT messes up your hormone balance, which means you might become more emotional, have hot flushes/flashes, put on weight, lose muscle tone, get bigger breasts, lose interest in sex, etc. These effects are short term and should have gone away again a while after HT finishes. HT should do the work by starving the tumour of testosterone which is one of the things that makes it grow.
There may be a permanent effect on the quality of bone structure however (a bit like having mild osteoperosis)
(If I am honest I am thus not keen to ever have HT)
I also looked into RT. And I thus went into RT with this in my head regarding side-effects.
Short term the RT would make me tired, might give me diarrhoea or blood in my stools, or make me feel like I needed to do a BM all the time; it might make me feel sick or nauseous and might make me need to go to the WC more often. Well I am just over half way through and so far I am tired and do have to pee and poo more frequently. If I sit still for too long then I also get a slight tenderness in my skin on my butocks in the area where two of the beams go in.
Things will no doubt get worse, but the short-term side effects should go away within about
6 months of the RT finishing, and some aspects should get better much sooner, like tyhe sore skin.
Nothing was said about
any short term side effects of RT on my erection etc, and I have yet to notice any. Being tired gets in the way anyway, but I've been getting woken by nocturnal erections three or four times a week, so some systems are still functioning okay.
Long term what I understand is that it is likely that your level of continence and sexual function will never get any better than the level they have reached when RT starts. And that over time (meaning ten or more years) things will get worse.
If the RT works then it will take longer tio work that the 33 sessions, as the tumour does not "die" within those 33 sessions, but as a resuklt of the damage caused by the 33 sessions, so I will not be getting my PSA tested again till about
3 months after it finishes. Another visit to the world of PSA anxiety coming up for certain.
And Past developments have also shown me that not everything goes to plan on this journey. So I am waitijng cautiously for this stage to end. I cannot quote a source but I thought that something like 30% of surgeries are not 100% successful and need to be followed up with salvage RT, and that the same percentage goes for the RT, thus RT will not deal with it for 30% of us.
So all one can do is hope that we're in the right group.
Age at Dx 48 No Family history of Prostate Cancer
Married 25 years, and I cannot thank my wife enough for her support.
April 2009: PSA 8.6 DRE: negative. Tumour in 2 out of 12 cores. Gleason 3+3.
RALP (nerve-sparing) at AVL-NKI Hospital Amsterdam on 29th July 2009. Stay 1 night.
Partial erections on while catheter still in. Catheter out on 6th Aug 2009.
Dry at night after catheter came out
Post-op Gleason 3+4. Tumour mainly in left near neck of bladder.
Left Seminal Vesicle invaded, (=T3b!)
no perineraul invasion, no vascular invasion. clear margins,
Erection 100% on 15th Aug 2009, but lots of leaking of urine
Stopped wearing pads on 21st Sept 2009
Pre-op style intercourse on 24th Oct 2009 !! No use of tablets, jabs, VED etc. but...
Nov 17th 2009 PSA = 0.1
Can still get erections okay, and almost no leaking of urine, but since December 2009 I don't have orgasms, instead I just have intense pain in place where prostate used to be.
Mar 17th 2010 PSA = 0.4!!! referred to radiation therapist
April 13th 2010 CT scan.
April 28th 2010 Started Radiation Therapy (66Gy - 33 sessions)
Post Edited (English Alf) : 5/22/2010 6:43:34 AM (GMT-6)