Salvage Radiation Advice

The Mayo doesn't use the ultra sensitive test they say it's unnecessary so that's good enough for me!

Larry

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Male 63 DX @ 60
Dad had PC
2002. Psa. .08
2014. Psa. 3.8
2016. Psa. 19
3-08-17 RP Mayo,Mn
Gleason 9, pt3bno, SVI, EPE, 35 LN-
4- 17 Hernia surgery
6- 17 psa 0.13
7- 17 psa 0.12 3TMRI coil - clear
8- 17 shoulder replaced
10- 17 psa 0.16
10-12-17 Lupron
12- 17 psa <0.10
12-18-17 SRT
2-7-18 SRT done 72gy
4-18 psa <0.10
10-18 psa <0.10
3-19-19 Laminectomy Surgery
5-8-19 psa <0.10
10-19 <0.10

In 2036 I’d be 74

George_ said...
My first thought was, this is a clear trend of the PSA value, one could already radiate now.

However, after I calculated your PSA doubling time I recommend to wait. You have a doubling time of 33.7 months or 2.8 years. So you will reach the PSA value of 0.2 in August 2021. If you want to do a PSMA PET/CT you will have to wait until April 2025 when you reach 0.5.

So I do not know what the objective of this salvage radiation shall be. If you do nothing and just observe, you will have a PSA value of 8 ng/ml in 2036 when you are 94 years old. You will have no symptoms until then. And it is likely that you will die for other reasons until that time. In 2036 you could start with ADT, if required.

I calculated the PSADT from 5/18 - 0.09 to 7/19 - 0.12.

I finished SRT today. The side effects were mild, mostly gastro distress. Two months until the first PSA.
The only bad part was the pre-treatment insertion of the 3 Calypso beacons for tracking purposes. This was NOT fun.
The RO said it was clearly worth it due to the increased accuracy and focus of the radiation beams.

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· Age at Dx: 60
· PSA: 01/2012: 6.7
· Biopsy, 18 cores, Dx, Gleason 4+3=7 in 4 cores: 01/2012
· open RP: 03/2012
· Post-Op Report: pT3a pN0 MX, Gleason downgraded to 3+4=7, Margins-, SVI-, Focal EPE+.
· PSA: <.03 for 4 years, 6/17 .04, 7/18 .07, 1/19 .11, 8/19 .18.
9/19 started SRT. SRT completed 10/19. 40 fractions, 72 GY.