Any studies showing value of SRT prior to BCR, but not adjuvant ?

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goodlife
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Date Joined May 2009
Total Posts : 2692
   Posted 1/21/2011 7:14 PM (GMT -6)   
I find lot's of info on ART and it's value within 4 months of RP. As a G9, I considered ART, but delayed it because of incontinence.

Is there any value to doing it now, with a PSA of .02 ?

Goodlife

BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 1/21/2011 7:22 PM (GMT -6)   
How long has it been since yoiur surgery?
Dx PCa Dec 2008 at 56, PSA 3.4
Biopsy: T1c, Geason 7 (3+4) - 8 cores, 4 positive, 30% of all 4 cores.
Robotic Surgery March 2009 Hartford Hospital, Dr Wagner
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive - tumor volume 9%, nerves spared, no negitive side effects of surgery.
PSA's < .01, .01, .07, .28, .50. HT 5/10. IMRT 9/10.
PSA's post HT .01, < .01

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 1/21/2011 8:01 PM (GMT -6)   
Or do you call it delayed ART?

I doubt you'll find such a study. But that does not mean it won't be effective. Most of the ART studies I have seen are on post RP cases within a year of the RP. Some are 6 mos. post RP. I would think there is some benefit since ART is considerable better than salvage therapy in regards to biochemical failure rates. Still you might have to make that decision on your own. It raises a host of questions on doing it with or without ADT.

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
RALP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 1/21/2011 11:43 PM (GMT -6)   
BB

I am 21 months out.

Tc,

Yes, I know, that is the next question. With a low PSA, I am thinking that Rt and Ht may be very effective in wiping it out. On the other hand, it may just be wistful thinking.

I have heard conflicting stories on BCR post op. Some imply that the longer it takes for PSA rise, the more likely it is localized in the prostate bed. Other opinions seem to say the opposite.

If I knewvthe answer to that million dollar question, I could make a better decision. If the PC is localized, then the Rt will be effective, and no need for Ht at this time. If however, it has gone systemic, then now or later may not make much difference. Might as well save the Ht bullets for the last non-curative approach, for a few years of extended life.

I am looking for arguments not to pursue Rt now. Will be going to Cleveland Clinic to see what they say, and may go to UMich as well.

Goodlife
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01
15 month PSA <.01

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3998
   Posted 1/22/2011 1:37 AM (GMT -6)   
Goodlife -- i commend you for being proactive with your disease!  best of luck to you.
 
ed
 
 
age: 55
PSA on 12/09: 6.8
no symptoms, no prostate enlargement
12/12 cores positive....gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 1/22/2011 6:55 AM (GMT -6)   
Goodlife,  I was able to find a reference to a study that might address your question.  Here is what the author said:
 
Nielsen(6) said, referring to trials
comparing adjuvant with salvage radiation,
“Since these trials were designed, experts have come
to understand that the results of salvage RT are very
sensitive to the timing of therapy, with the greatest
benefit seen in patients initiating salvage RT at early
PSA rise after surgery. In the context of this evolving
understanding of salvage RT, the trials do not
show that adjuvant RT is superior when delivered in
accordance with the best-available evidence.”
 
 
I started SRT at the first sign of a rise and have no regrets.  My thoughts on HT are the same as yours - will start it when I need to.
 
Carlos
Dx 2/2008, age 71, PSA 9.1, G8,T1c. daVinci surgery 5/2008, G8(5+3), pT2c. LFPF, good QOL. PSA <0.1 for 2 yrs. PSA rose to .2 at 30 months, started SRT 12/15/2010.
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