Would you consider offering salvage radiation to a patient with castrate resistant prostate cancer who has never had local therapy and has no evidence of lymph node or distant metastasis?
This is a patient who would have been an appropriate candidate for radiation upfront, but was managed with androgen deprivation therapy instead. On the one hand, I feel that radiation may be the only salvage option, and it's very well tolerated. On the other hand, would I just be giving a patient side effects from treatment without any benefit?
Answer from: Radiation Oncologist at Academic Institution
It's hard to give a great answer without knowing more information, such as the PSA, Gleason score and T-stage at presentation, why he was treated with androgen deprivation alone up front, what AD he was treated with, how long he was under treatment before he became castrate resistant, and what ...
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Answer from: Radiation Oncologist at Academic Institution
I have treated patients in this situation several times over the years and none of them were ever controled over the long haul. They all appear to fail. Thus, it appears that whatever the changes are that make the prostate cancer hormone insensitive also make it very difficult to cure with RT. This ...