With the change in my PSA over the last year, you can bet that I’ve been seeking every bit of information as to what it means and what to do about it. One of my go-to resources for the latest information in the field has been The “New” Prostate Cancer Info Link.
On 21 September, they published the following blog post that really piqued my interest:
Very early salvage radiation has up to fourfold better outcomes and saves lives
It’s certainly a topic of discussion for my next urologist visit in December. By the study’s definition, I’m still in the “very early” group—the group with the best survival if salvage radiation therapy (SRT) is started while I’m still in that group.
If we have to go down that path, my biggest concern with starting SRT is knowing that we’re actually radiating where the cancer is located. That concern is amplified if imaging can’t show where the cancer’s actually at, and we just radiate the prostatic bed because that’s what makes the most sense. Why risk some long-term, potentially nasty side effects on something so uncertain? (Yes, I know nothing is certain dealing with cancer.)
Of course, this is just one study and making a decision on it alone would probably be unwise.
We’ll just have to wait for the December PSA readings to come back and go from there.
On a happier note, I took a little drive through the country last week to tackle a few things on my travel bucket list: October Odyssey: The Mountain West. Check it out if you want to see what it was all about.
Dan's Journey through Prostate Cancer 
I’m not an md but I wouldn’t be too quick to start salvage therapy. Be sure it’s really back.
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I agree, Jim. Whatever December brings, you can rest assured that I’m going to be cautious and deliberate in my next steps, if any are needed.
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Dear Dan,
I am in a very similar situation except that I underwent radiation therapy four years ago. My PSA is currently .26 but I have had two successive increases. I recently had two appointments with medical oncologists (one at a renown institution) and both are very reluctant to start any type of salvage treatment until recurrence is confirmed, which typically would require a PSA of 2.05 since my nadir was .05. In their opinion, yes, it places a patient at a disadvantage to delay treatment but on the other hand, how is it possible to diagnose, let alone treat, when the recurrence and the location of the recurrence cannot be determined due to the lack of measuring tools. As we travel our roads it might be helpful to compare findings if our respective PSAs continue to increase. I will check back with updates and to see your update. Or have your people call my people.
Bob
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Hi Bob,
Thanks for sharing your story. I agree. I’m in no rush to start salvage radiation therapy until we know what we’re truly dealing with for the very reasons you mentioned. Plus, I’m not keen on possible long-term side effects from SRT. I just have this gut (irrational?) feeling that if I were to start SRT, I’d draw the short straw and incontinence and ED issues would rear their ugly heads.
I’m going for my next blood draw the week after Thanksgiving, so I should get the next piece of the puzzle by early December.
Thanks again and definitely keep me posted.
Dan
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Dan,
I had 39 treatments and 78 gy over 39 days. I have a small prostate. Drink prune juice to empty your bladder just prior to each treatment. I went to a renown cancer center (they have the newest equipment) and I have not experienced any side effects. If I went to sleep and woke up 39 days later, I would never know I underwent radiation treatment. So don’t worry too much about that, but be sure to go to a center with the current technology and experience.
Bob
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