Good Questions best answered by doctors. However will share my experience.
Management of Recurrence from any modality depends on the failure, is it local or has the cancer escaped the local therapy. I will discuss only local failures.
Local failure from surgery is typically treated with IMRT and may in conjunction with ADT depending on the risk of cells that have escaped to the area around the prostate capsule. Some methods to detect, local failure are, bone scans, CT/MRI and PSA.
There is a clinical trial using the CyberKnife to treat IMRT failures. Not sure if this study includes Proton Therapy and CyberKnife(very few failures) failures. Dr. Don Fuller, San Diego, Calif. is the Principal Investigator for this study.
Thank you for your post. I am seeing a radiation oncologist in two days and a urologist with a lot of robotic prostatectomy cases next week. I will try to compare CyberKnife with Brachytherapy. We all want the right treatment with minimal side effects and no recurrence, but we also need to prepare ourselves, in case we have an ongoing battle on our hands. To understate the situation...this is super hard.
Glad you are taking time to make an informed choice.
When we get the news “you have prostate cancer” it is a lot to absorb. We all go through a similar emotional process. To minimize the concern for recurrence maximize your chance for cure.
Suggest you look at studies comparing open vs roboitc surgery. When meeting with a radiation oncologist it is important to understand that he will offer to treat you with the tools that he has and knows. Men with localized PCa will have a good chance of cure based on the historical bar (range) set by decades of surgery. In my opinion (interpretation of published studies) Radiation advancements of the last 20 years has moved the bar for cure to the mid to high 90% and reduced the risk of side effects. Suggest you take time to look at each radiation modality to understand the technology and theory for each. Look at RBK1111’s new patient thread.