• Radiation after total prostate removal

    Asked by RLECLAIR on Tuesday, March 25, 2014

    Radiation after total prostate removal

    Boyfriend had his prostate removed in Nov 2013. Yesterday the urologist said he wants him to see a radiologist because the cancer was SO close to the edge of the prostate it is probably a good idea to have the area radiated to make sure the cancer did not break thru. He said there are no tests to find out, just get it done. Has anyone else been radiated AFTER total removal. He is Very unhappy about being told this.

    8 Answers from the Community

    8 answers
    • dan7264's Avatar
      dan7264

      Definitely get a second opinion or third. Try to find another radiation Onc doctor, hopefully one that is not in the same club circle as your present doc. I also wonder if there are cancer centers that just specialize in prostate cancer that you could get a second opinion from.

      Radiation, especially in the stomach, bowels and colon area can cause a cancer of its own, it might be 10 to 15 years down the road, but why cause that if you never needed it in the first place?

      over 5 years ago
    • cam32505's Avatar
      cam32505

      I had radiation for uterine cancer. There are many side effects to radiation in the abdoman/pelvic area, as so many vital organs are in this area. I spoke to many men who were there for prostate cancer. One of them told me his doctor didn't recommend radiation, but he had a relative who was a doctor and they suggested radiation. One of them had a recurrance from about 8 years before. He said they told him the radiation might not work, but it would take a long time for it to spread and he would probably not die from the prostate cancer. With most treatments, it seems we have the chance of another cancer occurring. My mother had throat cancer and only had surgery, yet 20 years later, she got leukemia. No radiation. So, I guess some of us are just prone to getting cancer, so we might as well get rid of it in the present and just take what comes down the road. But, second opinions don't hurt. As you know, it is just a doctor's opinion. It really has to come down to your decision to treat or not.

      over 5 years ago
    • Gaffer's Avatar
      Gaffer

      Radiation "just in case" is a pretty serious step. Never heard of that having worked eleven years in Urology, but treatment guidelines can change. I have been out for 12 years. Personally I wouldn't pursue it unless my PSA started going up but that's just me. dan7264 got it right. Get a second opinion and his suggestion of a cancer center that deals with a lot of prostate cancer is a great choice. If I have recurrence I will be heading for a cancer center for treatment.

      over 5 years ago
    • StanInVA's Avatar
      StanInVA

      You have a tough choice to make. I had a prostatectomy but PSA did not go to zero (was only 0.03 but still detectable) so surgeon sent me to the radiation oncologist for consult. Since radiation PSA has gone to zero. I did see two radiation oncologists before going forward with treatment. They were in different cities (one local and the other at a teaching hospital where I had the surgery done) which made me comfortable they were objective. There are some side effects of radiation. Digestive system is disrupted (some of which is permanent) and fatigue that goes away over time. The referral from the surgeon was because of the PSA. However, both oncologists said I was already in the gray area of being a candidate for radiation because the cancer had spread into the seminal vesicles that by their definition a positive surgical margin. The surgeon did not view that as a positive margin since the cancer cells were not on the outside of either the prostate or the seminal vesicles. As far as tests go, I had an MRI scan done but it showed nothing. Both doctors said it was very doubtful it would find anything as a very low PSA indicates very few cancer cells that would not show up on a scan. I was told there has to be a concentration of cells in one area to show up on the scan. The reason I had it done was just in case it showed something it would help in where to focus the radiation treatments. With my PSA now at zero I feel I made the right choice.

      over 5 years ago
    • Kenster's Avatar
      Kenster

      I have found that doctors do NOT all agree with each other in this area. I had my prostate removed in Sep of 2011. Afterwards my surgeon, who is known as one of the best in the country, told me that it is very important that I follow up with radiation treatments. However, my oncologist recommended against it. I didn't know which way to go. I even got my surgeon to talk to my oncologist, but they came to no agreement. I began to research and talked to a number men that had gone through a prostatectomy. Some of them I knew and some I contacted over the Internet. About half of them received radiation afterwards, even though the PSA was zero. The other half did not. It just depends on the doctor. I know my surgeon is very good and I have a lot of faith in him, but I also have a lot of faith in my oncologist. In the end the decision was up to ME. In my case I decided to have the radiation treatments. Maybe because my cancer was a gleason 9 and my surgeon was so adamant about having the treatments. You can, and should, get more opinions, but in the end it will be your decision to make.

      over 5 years ago
    • RickT1953's Avatar
      RickT1953

      Sounds like there is no clear cut answer from the medical community. The first doctors I went to told me they wanted to do the surgery and follow up with radiation and drugs. For a second opinion I went to City of Hope in the LA area and the doctor there said let's do the surgery, test you and see where it's at. No further treatments pending the tests taken over time afterwards. I went ahead with City of Hope. In my case I was also Gleason 9 and the cancer had spread into the seminal vesicle but was negative for the lymph nodes in the area. Yes high Gleason means a higher risk of recurrence -- for 25% of the cases as I understand it. My doctor feels you deal with it if and when it happens. Since the operation 1 and 1/2 years ago my PSA has held steady at 0.04. The doc at COH says that is not an issue and is not concerned. No further treatments are suggested and I've gone from being tested every 3 months to every 6. I'm sorry if this isn't helpful but I would think twice about doing the radiation.

      over 5 years ago
    • Ross' Avatar
      Ross

      If you read my story you will find someone that had a radical and was advised to follow with radiation after 3+ months of surgery recovery. I also had a double hernia op in between. I underwent 2 months of daily radiation with minimal side effects. Was also on hormones which continued for another 3 1/2 years. Today I have no active cancer with a .02 PSA. Feel good, play tennis and exercise. ED is an ongoing fact.
      A survivor, Ross

      over 5 years ago
    • martian's Avatar
      martian

      Have you had any PSA follow-ups? If you get a chance to read Gerald Chodak's book, "winning the Battle Against Prostate Cancer - you just might get the treatment that is right for you. You just can't tell what the DNA molecule is doing in the nucleus of the cancer cells if there are positive margins left. You can't predict what will happen- in some men it is a cure; in others the stem cells from the cancer cells could just be lying dormant. There are too many variables. I would suggest you go to the James Brady Institute to obtain a Kattan Nomogram to determine your probabilities. (not knowing your original clinical stage and pathologist report - you could put your stats in their algorithm. They will give you some answers in terms of matastasis, etc. I chose IMRT radiation with a gleason score of 8 and am just monitoring my situation with regular PSA tests and a DRE check. Since you had this done in November of 2013 - you must have had some follow-up tests! Your choices seem to be: 1. Do nothing and see what happens with periodic check-ups. 2. Complete the radiation follow-up with a salvage attempt disrupt all potential cancer cells within the seminal vesicles and nearby lymph nodes. (some men do better and some do NOT. as Gerald Chodak, M.D. says in his major analysis of all treatments. It all comes down to making a choice or not making a choice. Check out the PCRI hot-line - they may help you clarify some issues that you are facing. Do as much research as you are able - then make the decision that is most comfortable with you. Monitor your situation very carefully for any changed symptoms. Definitely look into the "nutrition" factor; it's very important that we all do. Martian, a survivor. Get lots of opinions as long as your insurance issues are not a factor. Good luck!

      over 5 years ago

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