From what I understand about radiation.... It destroys the cancer cells in the prostate and the healthy cells regenerate. Does that mean that you can develop new prostate cancer cells after RT?
The way you seem to be describing it is not quite right—technically the precise answer to your question is “no”—but you are definitely not off-track in the big picture...let me explain...
Primary radiation therapy does indeed ATTEMPT to “blast” and destroy the cancerous prostate with beams of intense energy, without “blasting” too much around it. But it is definitely a too-little/too-much balance. Two things can happen which can end up with the patient still having “cancer” afterwards...
In the first case, the RT may be insufficient for any one of several possible reasons to adequately and completely destroy all the prostate and the prostate cancer cells in the prostate, or in some cases the prostate cancer cells outside or around the prostate (the differences in these cases in the context of RT could be a whole other detailed discussion for another day). Of course, immediately after treatment the answer to whether all cancer cells were destroyed is unknown to all as there is nothing to actually “see” from the outside of the patient, and all the patient & doctor can do is monitor the blood levels of PSA produced by the “blasted” prostate into the patient's blood—looking for the PSA to go down and not come back up. If it stays down, we say "cured." If/when PSA does go back up, that’s what we call recurrent
prostate cancer (or BCR, a biochemical recurrence), and a “failed” primary treatment. Eventually, usually months or years later, a secondary treatment is necessary for primary treatment failures, or at least recommended (and note that secondary PC treatments are more challenging/limited after primary radiation versus primary surgery...another different in-depth topic for a different day). Bottom line, the instance I have described is indeed “prostate cancer,” and more specifically it is “recurrent
prostate cancer.” This RT treatment failure happens too frequently to be called “rare,” but is not necessarily “common.” Also, there is no particular “regeneration” of healthy cells which have been “blasted” (beyond normal cell reproduction taking place everywhere in your body) ... this being a part of your original question.
By contrast, a second type of “cancer” after RT which you might have also heard about
is indeed “rare,” but definitely happens and there have been men here at HW/PC with this condition...a “secondary
cancer” which is not prostate cancer but instead is caused by the primary radiation treatment itself. Bladder cancers, rectal cancers (most typically) and others have been traced in theory/likelihood to the “blasting” of the region around the prostate. (You've heard, no doubt, that too many x-rays to a particular part of the body can also cause cancer...what I am describing here is akin to the slow but repeated application of lower energy x-rays extrapolated to the rapid, intense application of high-energy radiation via RT treatments.) Biopsies of these "new" tumors reveal, as I indicated, a cell pattern very different than PC cells...so not PC, but a new, different cancer. Note that more common than full-blown rectal or bladder “secondary cancers” is the common occurrence of rectal or bladder “problems” from having those areas collaterally “blasted” (we call these "RT side effects")...unintended consequences of the prostate radiation treatment, some of which are short-term and resolve often with additional medications or treatments, others are long-term or "late-term," showing up months or even a couple years after treatment and often end up being "chronic."
So, in very direct response to your question, the first case I described here is indeed prostate cancer, but it is “recurrent” PC not “new” PC. The second case I illustrated is indeed a “new” cancer, but it is not prostate cancer.
Perhaps now you are getting a feel for the old saying that the prostate cancers “cures” are often worse than the disease itself.
It looks like you created two different threads yesterday, Leah...this one, and another completely different topic about
"treatment regrets." The question about
"regrets" is a very nuanced question and the broad question can mean really different things to different people based on their widely varying case situation. I'll try to post a reply to your other thread later today if I can find time. I just returned from a 3-day weekend to NC for my step-father's funeral, and actually have a pile of work in front of me today...sad!
Post Edited (Blackjack) : 3/4/2019 12:47:08 PM (GMT-7)