What is Salvage Radiation Therapy?

Salvage radiation therapy is a type of cancer treatment given to men who had their prostate removed, yet their prostate-specific antigen (PSA) levels start to rise. Biochemical recurrence is a term used to denote prostate cancer recurrence only detectable by a rising PSA level.

Is Salvage Radiation Right for Me?

Men who have a biochemical recurrence of prostate cancer may choose salvage radiation. After having surgery to remove the prostate, your health care team uses a blood test to check your PSA level. A PSA level of ≥0.2ng/mL after prostate removal surgery indicates biochemical recurrence of prostate cancer, and your health care team may suggest SRT. Imaging tests, such as a pelvic MRI, CT scan, bone scan or a PET scan may also be used to see if salvage radiation is right for you. In some high-risk cases, your health care team may offer a minimum of four to six months or up to 24 months of androgen deprivation therapy (ADT) in addition to SRT. ADT is a hormone therapy treatment that lowers testosterone. ADT slows prostate cancer progression when prostate cancer has spread away from the prostate or returned after other treatments. There are many types of hormone therapy for prostate cancer treatment, including drugs and surgery.

Choosing the appropriate time to receive salvage radiation is of great value. Some men will benefit from salvage radiation at very low PSA levels. Other men may be able to safely delay salvage radiation until their PSA levels are higher. The exact timing of SRT for your individual situation is a topic you should discuss with your health care team. Patients with genetic markers linked to high radiation sensitivity may allow for more targeted treatment options, which may help the outcome of salvage radiation. Mutations in genes like BRCA1, BRCA2, ATM, CHEK2 and PALB2 are commonly looked at due to their role in DNA damage repair, which may impact how a tumor responds to radiation.

What are the Benefits and Risks of Salvage Radiation?

As you talk with your health care team to learn if salvage radiation is right for you, it is helpful to know the benefits and risks.
Possible benefits of salvage radiation may include:

• Curing prostate cancer in men who have a biochemical recurrence
• Reduced need for hormone therapy in the future
• Stopping or reducing the spread of cancer

Possible risks of salvage radiation may include:

• Bowel issues, such as loose stools or blood in your stool
• Urine issues, such as blood in your urine, pain when passing urine, the need to pass urine often or quickly, less control of urine and scar tissue in your urethra
• Sexual issues, such as problems with erections

Side effects may happen during the time of treatment, many years later or not at all. Most side effects are short-term, mild to moderate, and can be treated. Some side effects may be worse and harder to handle. Talk to your health care team about any side effects you have during or after treatment to decide next steps.

What Should I Expect During Salvage Radiation?

Salvage radiation is given by a radiation oncologist who works closely with your urologic surgeon. Salvage radiation most often targets the prostate bed and sometimes nearby lymph node tissue. Most men get a course of radiation, five days per week, over a four- to eight-week period. Sometimes a course of hormone therapy or androgen deprivation therapy (ADT) will be given with salvage radiation. You should talk this over with your health care team to decide if hormone therapy with salvage radiation is right for you.

Reference

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radiation, radiation oncology, salvage radiation, prostate cancer, prostate cancer treatment

Radiation Oncology Centers

Inova Loudoun Hospital
44035 Riverside Parkway, Suite 100, Leesburg, VA 20176
Phone: 703.858.8850
Fax: 703.858.8870

Reston Hospital
1850 Town Center Parkway, Reston, VA 20190
Phone: 703.689.9330
Fax: 607.324.7615

Virginia Cancer Specialists
10301 Democracy Lane, Fairfax, VA 22030
Phone: 703.934.4450
Fax: 703.934.5533

Radiation Oncology Associates
Inova Fairfax Medical Campus
8081 Innovation Park Drive, Fairfax, VA 22031
Phone: 703.776.2986

Cancer Center of Lake Manassas
7901 Lake Manassas Drive, Gainesville, VA 20155
Phone: 703.753.4045
Fax: 703.753.8037

Shenandoah Oncology
400 Campus Blvd, Suite 110, Winchester, VA 22601
Phone: 540.536.8912
Fax: 540-722-2635