Last visit questions for RO post-SRT?

Great questions. Let me take a stab:

1. It depends on your PSA.

2. Hopefully, as this is a long term situation. If the SRT was not successful I will hand you off to a very good medical oncologist.

3. Maybe between 18 and 36 months, give or take. Let’s look for a low and stable PSA. If it starts rising I will send you to the medical oncologist.

4. Yes. All treatments have side effects. Hopefully they will be mild and manageable. SRT on top of surgery can bring out the worst side effects, but let’s hope you will be fine. That you have minimal side effects following surgery, you have a better probability of having minor SRT side effects.

Paul, you are doing all you can and appear to be in very good hands. This is a marathon slog for most and that is preferable compared to the cancers that claim their victims in months. Stay calm......strengthen yourself both physically and mentally......and have patience. With only one core positive you have some real advantages, but an uphill battle.

Best wishes.

You've got all the bases covered, Paul.

For the first year, I've been checking in with my RO every 3 months -- sometimes an office visit, sometimes by phone (he's a plane flight away).

My RO told me at the end of SRT that he'd be surprised if any SEs developed. Given what Gary and others have experienced, that seems overoptimistic. But in fact I've had no SEs (your mileage may vary).

I don't think it's possible to know how effective the SRT is -- unless of course it outright fails soon after the T begins to recover. If, say, I get three years of undetectable PSA and then it starts rising, how effective should I consider the tx to have been? Is knocking the PSA down for three years "effective"? What about five? Or is anything less than a cure ineffective? Beats me.