Questions for a Adjuvant or Salvage Radiation Interview.
1. How many prostate cancer patients have you
treated with adjuvant/salvage radiation?
2. How has your practice of
salvage treatment changed, if at all?
3. Is there any kind of scan
that you recommend to rule out metastases that might be useful at my current
4. What is the probability that
I need salvage treatment? Do you calculate that from a nomogram?
5. Do you think I should get a
Decipher test to find my probability of metastasis in the next 5/10 years? Do
you know if my insurance covers it? What do you think about their PORTOS score?
6. How large a dose do you propose
for the prostate bed? (should be
near 70 Gy -72 Gy)
7. Do I need pre-treatment, concurrent
or adjuvant ADT?
b. What's the evidence that it's
c. For how long?
8.How do you decide whether to
treat the pelvic lymph nodes?
a. If so, at what dose?
b. How do you plan to prevent
c. How will you account for the
separate movement of that area and the prostate bed?
9. What do you think of doing
this in fewer treatments (hypofractionation)?
10. What kind of machine do you
use? (e.g., RapidArc, Tomotherapy, etc.) Why do you prefer that one?
11. What is the actual treatment
time for each treatment? (faster is
12. What kind of image guidance do
you propose? fiducials in the prostate bed? Using the fixed bones only? Soft
13. How will inter- and
intra-fractional motion be compensated for?
14. What measures do you propose to spare the bladder and rectum? (ask about treatment margins and dose
15. What side
effects can I reasonably expect, and how do we handle them?(discuss in detail!)
probability of a cure can I reasonably expect, given my stats? Is there a
nomogram you use to come up with that?
17. How will
we monitor my progress afterwards, both oncological and quality of life?
best way for us to communicate if I have a question or issue?