Radiotherapy without hormone therapy

Tony, my oncologist thought HT along side salvage RT would be to toxic for my stricture. The salvage RT didn't get all the cancer because it wasn't all in the prostate bed.

Lots of research into RT with or without HT, but I don't know if there is a majority decision on which is best.

Thanks Chris 

The thinking seems to be that hormone therapy benefits reduce as the power (dose rate) of the radiotherapy increases and the duration of the radiotherapy treatment reduces. There comes a point where the benefits of hormone therapy no longer outweigh the potential downsides. Exactly where this boundary is may be open for debate, and may also depend on the aggressiveness of the disease. Certainly, you could ask your oncologist what the difference in cure rate is in your case comparing with and without hormone therapy.

A merry Christmas to all 🎄

Rgds

Dave

Tony. 

I can only speak from my experience. I wanted to avoid HT and was told that had my Gleason and stage been lower that would have been possible. I assume that was the judgement that was made with you. I was less fortunate and whilst the combination will no doubt offer hope for my Gleason8, I shall bear the side effects 

Good luck 

Gabriel 

Tony 

I can only recount my experience and that is what I am committed to doing. I am not some armchair punter nor some sage talking about his mate, his dad or his brother.

It is going ok so far as I can tell. There is definitely fatigue but I am trying to change my diet and religiously sticking to 10000 steps a day. In my mind cutting out booze, meat,sweets and saturated fats, if nothing else will stave off diabetes and weight gain. Both are associated with hormone treatment.

For me it is interesting, but I was only prescribed Zoladex with no Bicalutamide or Flutamide. It's interesting because every medication brings positives and negatives. So I may have less positives but less negatives than others.

I think that I have a very aggressive strain so I have faced it as a death sentence. In reality we are all going to die, it's just a wake up call for me that my death will no doubt be sooner than that of my two brother's .

I also hope for a quality of life but practically I realise that will diminish.

I wish the forum was less dominated by the few and that there was a greater participation of individuals recounting their live journeys.

Stay in touch 

Gabriel 

Seems there is now some evidence that even though I have G9 T2cN0M0 (negative PSMA/PET) there is equivalence to longer RT and 18-24 months ADT.

Given my age and other health issues from childhood polio (low muscles mass) it seems a good option - of course that doesn’t help me overthinking and worrying about the future especially when so many post talk of the standard RT of 72Gy over 7-8 weeks and 2 years ADT.

37 x 2Gy = 74Gy and 20 x 3Gy = 60Gy are equivalent treatment doses to the prostate which handles higher dose rate well and is more effective as a treatment, so less needed for the same treatment effect. The shorter your radiotherapy treatment, the lower the total dose needed. At one extreme is HDR brachy which is typically 2 x 15Gy = 30Gy over 2 days, and at the other extreme is LDR brachy which is 170Gy over 200 days. These are roughly equivalent treatment doses, but the total dose is widely different because of the different dose rate and treatment duration.

If other organs are also being treated such as lymph nodes, they can't handle the higher dose rates the prostate can, so that's why such a treatment will be delivered as 37 x 2Gy.

Edited by member 05 Jan 2023 at 13:36  | Reason: Not specified

Gys or Grays is a measure of the absorbed dose of radiation to tissue.

For X-rays the number of grays is equivalent to the number of Sv or Sieverts which takes into account the biology of the tissue being irradiated.

in the UK the average yearly exposure is around 0.0027 Sieverts. For a standard chest X-ray the dose will be around 0.0002 Sieverts. 
When we look at doses of 60 Grays that is the equivalent of around 22000 years of background radiation which is enough to kill cancer cells! 
https://www.radiologyinfo.org/en/info/safety-xray

Hope that isn’t information overload.