Dear sir. What is the best time to opt for radiation therapy after hormonal injection .i have been diagnosed with stage 4 prostrate cancer spread to the lymph nodes but not to bones. And have recently taken my second shot of hormonal injection in April first week. My doctor suggested that I take the second shot since the PSA had fallen to 3.5 after the first injection. Can you advise if I can delay going for radiation till the time my PSA is being controlled by hormonal injections.

Dr. Nikhilesh BorkarOncologist14yrs exp

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Prostate cancer is treated by surgery or radiation if in early stage and low risk disease (based on Gleason score on Biopsy and PSA level). If locally advanced stage or node positive, then it is treated by radiation therapy with adjuvant hormonal therapy. If it has metastatic spread, then it is treated by hormonal therapy, which controls the disease from months to years, but does not cure it. If very early stage and Low risk, then according to the age, life expectancy and general condition of the patient, active surveillance or watchful waiting may be advised. I cannot comment about the best treatment modality without seeing the Biopsy report, Imaging and knowing the age (47), comorbidities and general condition. If you want to share your reports and discuss this further, feel free to contact me directly.  

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