Defn. of Adjuvent Radiation

On my last visit to Ford, I was disappointed that the regular doctor I usually see (on Dr. Menon's Team) is no longer there. He moved to Miami!

Anyway, I was not impressed with the new guy I saw. Very young, in training, and just didn't seem that knowledgeable.

Anyway, when talking about the possibility of SRT, he kept calling it adjuvent radiation and I kept correcting him.

He said that if I start radiation before the official BCR (ie; before it gets to 0.2 and confirmed by a subsequent PSA as per AUA guidelines), then it is considered ART. Now, I realize it doesn't really matter what we call it, but I thought ART is when we start radiation immediately and don't wait for a reoccurrence. In other words, the INTENT is the determining factor. I also thought that ART by definition is done within a year of surgery.

Again, I'm not sure and neither was this doctor.

So, can anyone shed light on the technical definition of adjuvent radiation?

Incidentally, tomorrow is my first anniversary of my surgery. Why do I not feel like celebrating?

Mel

Mel,

Neoadjuvant - treatment given before primary therapy.

Adjuvant - treatment given after primary therapy.

Salvage - treatment for a rising PSA.

The main difference is that AR is done without waiting for signs of recurrence, while SR happens after a rising PSA. I don't think there is a magic time period to call it one thing over the other.

It's semantics. Let's call it radiation.

I'm in the same boat with HT. I may be starting that without PSA rising. What do we call this? Adjuvant HT? Crazy?

One year from surgery...you should celebrate...that was a long, hard year I'm sure.

Jerry L.

The old definition made adjuvant radiation as haven taken place within 6 months of surgery, and after 6 months, as salvage radiation, either with or without BCR

Just repeating what my original medical oncologist told me more than 10 years ago, Think its really a small point to haggle over.

That was "fairly" funny!!!

Mel,

I have been doing some thinking about this topic myself. I am 21 months post op. I was advised by Hussein to do ART within 4 months, but let incontinence take precedence.

As I see small increases in PSA, I have begun investigation into what I am still calling adjuvant, pre BCR. Going to local rad, Cleveland Clinic, and maybe back to Hussein. Will probably go to monthly PSA to check rate.

I hate to pull the trigger, shooting at nothing, but have been studying it. Incidentally, I have read that positive margin guys have some the highest success rates.

I think it is matter of semantics. I am trying to balance the qol issue with longevity, with prudence. If I think I can improve my odds significantly, with minimal qol effects, I will most likely do it based on my G9.

Good luck on your process.

Goodlife

Mel,

If there is any evidence that the cancer is returning, by Walsh's glossary, it is Salvage. So you are on target.

Goodlife mentioned Cleveland Clinic, which doesn't even use the term "adjuvant" in their book, only "salvage".

Fairwind never came to an undetectable PSA, so Salvage applies there too. But then maybe they were trying to salvage a little cash.

Goodlife -

a great example of the clear medical direction we get - my uro/surgeon believes in the "kill it before it grows" approach, so RT was on the books at the first post-op appointment.

My doctor(s) were more like 142. At least SR is another bullet when the enemy shows their head.