Post RARP Salvage Treatment
Posted , 2 users are following.
I had a RARP 3/28/2017. NO COMPLICATIONS, FEEL great, kept my weight down, been active except not exercising (lazy). Improving with urinary incontinence. Had Gleason score 4/3-7. Post surgery biopsy all margins clear. First PSA 10 weeks post op .15. Second PSA 5 months post op (yesterday-results today) .19.
Appointment with Urologist in 3 days (Friday)
VERY CONCERNED, trying to not freak out.
I know I am looking at TESTS.....PET scan, CT scan, MRI etc. Probable salvage Radiotherapy, ADT or hormone therapy to follow.
Anybody been there yet? Results? Short term side effects? Long term side effects.
Richard98806
0 likes, 9 replies
barney34567 richard98806
Posted
1. While the PSA post op didn't fall to zero, at least it isn't skyrocketing as mine did post RARP.
2. When or if the PSA doubles from the first reading of 0.15 I suggest a PSMA PET CT scan to verify if anything can be seen in and behind the prostate.
3. If something can be seen in a scan then SBRT, a type of radiation, may be recommended. (I had that and in my case it failed).
4. Don't rush into hormone therapy.
barney34567
Posted
Where I wrote "behind" I meant "beyond".
richard98806 barney34567
Posted
Where are you now with your PC and what other treatments have you undertaken?
barney34567 richard98806
Posted
In your case, ADT should not be priority #1. Wait until the PSA doubles. Then we can canvass the available options.
I suggest you wait 3 months from the most recent PSA and then retest the PSA.
By the way, did your post op pathology mention Perineural Invasion (PNI)?
barney34567
Posted
Sorry, "and as" should read "and it".
richard98806 barney34567
Posted
Don't believe PNI was mentioned. I will check tomorrow when I get up.
Thanks for your suggestions.
Hang in there brother.
richard98806
Posted
No PNI but one margin was not totally clear. My Urologist said on last visit. Anyway I am scheduled for a PET Scan with Axium (a specific radioactive dye to pin point the cells producing PSA) Probable treatment is 4-6 week EBRT.
Anyone out there have ERBT? SIDE EFFECTS, long term or short term? Effectiveness of the salvage radiation therapy?
My Urologist wants to do prior to ADT. Actually he didn't seem to keen on ADT.
barney34567 richard98806
Posted
Margin not so clear is a common result.
With your results I would not consider ADT.
When it comes to radiation, if one can see the lesions on a scan then SBRT is used a lot as it focussed the radiation on small lesions alone. EBRT is not as accurately targeted.
There are side effects of EBRT mainly fatigue and damage to sexual function. Damage to other organs eg rectum is a possibility.
I would do nothing until you get the result of the PET scan.
richard98806 barney34567
Posted
Damage to other organs, umm don't like that prospect.
thanks for the tips