How do you approach radiotherapy planning when there is no identifiable prostate tissue after HIFU or TURP?

For a patient with high-risk prostate cancer, would you use definitive or adjuvant/salvage prescriptions and dose/fractionation schedules? Do you consider hypofractionation? How do you decide on a treatment volume?

Answer from: Radiation Oncologist at Academic Institution

I am not sure why there would be no identifiable prostate tissue. There was apparently enough to detect cancer on biopsy, which is ultrasound-guided, so someone must have seen prostate tissue at that time. I suggest getting a high-quality MRI and a careful review. I would also order a PSMA PET for r...

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Radiation Oncologist at University of Western Ontario Schulich School of Medicine & Dentistry
With routine use of PSMA PET, we are picking up lo...

Radiation Oncologist

I have run into this situation a few times (post-ablation biochemical recurrence with no real glandular tissue in the prostatic ‘fossa’), and I haven’t really known what the best course of action was. This question is a bit generic inquiring about both a TURP and HiFU so I will try...

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How do you approach radiotherapy planning when there is no identifiable prostate tissue after HIFU or TURP?

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