Can Someone Clear This Up For Me?

I have read...

1) Local and regional prostate cancers are often curable.

2) Regional prostate cancer includes cancer that has spread to regional lymph nodes.

But I have also read...

1) Metastatic prostate cancer is incurable.

2) Metastatic prostate cancer includes cancer that has spread to regional lymph nodes.

So which is it? Bottom line? If the prostate cancer has spread to regional lymph nodes, but not to the organs, bones, or distant lymph nodes - is it curable or incurable? It's surprising that I can't find a clear definitive answer on this anywhere.

[Hidden]

I am confused, also. My husband now have cancer in his regional lymph nodes. His radiation oncologists proposed 28 addition radiation treatment with to cure the cancer. Yes, he said “cure” the cancer. The 2nd opinion we just received at at Johns Hopkins said that once it is in the regional lymph nodes, it is not curable. I know it will never be ‘curable.” It keeps coming back.

[Hidden in reply to Hidden]

That's what I mean. I've been told that this is regional so I still have a shot at a cure. I don't know what to believe anymore. I'm not sure the doctors know either.

[Hidden in reply to Hidden]

It’s great news that there’s no bone involvement. Much better and easier hopefully to manage. I was told I had a 50/50 chance to survive my initial treatment plan and I said “ hell ya! I took it.. this is a terminal disease. You will push it back and hopefully have years to enjoy life. Getting over the first hurdle is all you need to think about now.. who knows what lurks in our future.. The shadow knows... the rest of us just go day by day.. I think you are on the right plan. Others may suggest to try RP but I’d go with your Dr.. good luck dale339. !

[Hidden in reply to Hidden]

Actually, it was Dr. Pienta at Johns Hopkins who suggested I join a clinical trial that will attempt to eradicate the disease. The trial is for men who have had an RP. It will include up to 6 cycles of taxotere, radiation, and hormone therapy.

[Hidden in reply to Hidden]

Dr.Pienta sounds good.

[Hidden in reply to Hidden]

The good Rado Dr is being optimistic and is thinking that he will fix the current problem the nodes. He’s confident. That’s good. I feel he is right. John’s Hopkins is correct . No none cure .... we are in the first inning..My goals are short, just want to play in the next inning. Good luck to you.

[Dayatatime]

There is no definitive answer and there are no guarantees with anything about cancer. I look at the multimodal approach as a hail mary. It's a small chance at success with nothing to lose and if you end up making the catch you've won the game.

Ron

[Tall_Allen]

Usually when people speak of metastases, they mean detectable, distant metastases, which is designated as stage M1. M1 may be in non-regional lymph nodes (M1a), any bones (M1b), or visceral organs (M1c). Cancer in pelvic lymph nodes IS metastatic , but it has its own stage designation (N1). Because cancer migrates in the lymph (lymph nodes can act as traps for metastatic cancer cells) much more slowly than in the blood, there is a hope that the cancer can still be cured by whole pelvic treatment (either radiation or ePLND or both). Once it gets to such places as bone, abdominal LNs, or viscera, it is evidently systemic and currently incurable.

[BigRich]

Medicine is an art, not a science. If you are younger then 75, think about it; however, realize radiation has possible adverse side effects.

Rich

[Hidden in reply to BigRich]

Absolutely.

[Dr_WHO]

It can be a bit confusing, especially when you through stages into it. Stage 4 can cover prostate cancer that has metastasized to the pelvic lymph nodes and is called Stage 4D1, or by newer definitions Stage 4A. Cancer that has spread past the pelvic lymph area or bones is called Stage 4D2 or now Stage 4B. Recurring cancer is called Stage 4D3. I tell people I have Stage 4 “lite” (or Stage 4D1 or 4A). A better definition is the TNM ratings where the “T” stands for the primary tumor, the N stands for the nearby lymph nodes and the M stands for if the cancer has metastasized to the bones or distant organs. In that case I have T3N1M0. It is advanced, but not nearly as bad as it could be. The issue is how much of the cancer went past the lymph nodes. As one of my nodes was “100% cancer”, some cancer may of made it past the lymph nodes. That is why it is good to read your pathology report to see what it says about the extent of the cancer in the lymph nodes.

Listed below is some more information on it.

cancer.net/cancer-types/pro...

cancer.org/cancer/prostate-...

[Hidden]

There is no cure for stage #4 ....long term remission possible yes if very lucky... anyone that says there is a cure id be aware they are overstating optimism ...

[Emmett50 in reply to Hidden]

In our first meeting with a medical oncologist at a major cancer center, the doctor told us that my husband, while a Stage 4, still has options of “curative treatments” since his ca is confined to just outside the prostate. She specifically said that there’s a distinct difference between cancer that is locally metastatic and that in bones. Once it’s in bones, treatment is called palliative even though a man may live for a long time on ADT. My husband’s treatment is first ADT for 2 months with radiation of some sort after that. The specific radiation treatment will be determined in a consult with radiation oncologist on March 19th.

[Hidden in reply to Emmett50]

Whichever treatments are decided upon. I hope you have good results ,as I have . We all pray for a cure.. let’s use whats on hand in order to be here for that. With good advice from your drs you will do the right thing medically. I have my big yearly test and scans 4-10 . I take nothing for granted, I pray for us all to live as healthy as we can for as long as possible .The nature of APC is long term persistence... to eliminate Us. Stay sane in all this . That’s half of the battle...

[BigRich in reply to Hidden]

Lulu,

I will pray you have good tests. I believe, God in heaven has given me a good brain to make decisions regarding my treatments and to fight also ageism, age discrimination against senior citizens in the medical field. I am part of the medical team with my doctors or they are replaced. I have found many nurses with less education practice ageism, subconsciously. Today, I almost got the wrong injection, the nurse lied to me, for what does the old man know. I said wait I want to see the dosage on the package it was for 22.5 mg Lupron, when I receive 7.5 mg, Lupron, every 28 days. I got the correct dosage, for I asserted my patient rights. I have an earned Ph.D. and I am not ready to be out to pasture. That is the reason I am in my 20th year fighting this beast.

Rich

i

[Hidden in reply to BigRich]

I follow your advise . I remember at about 40 when people around 20 started calling me sir.. I felt like a kid , but not to them . In this disconnect between generations it’s never been larger due to my theory that people under 35 now communicate by tech mainly and have never learned respect for their elders . A flaw I believe in our society in general . My parents were the greatest generation and I was taught as a child to only speak when spoken to while around adults. That showed me to listen to elders and learn. I’ve had good friends and age doesn’t matter. Mom is 90 , still drives , still lives alone . she’s the one that taught me kindness . She tells me of the idiots disrespecting her in the medical field and in her daily life due purely to her age. People pray on the elderly in America. Many scams . They talk to her like she’s an idiot. She was Mensa society super high I Q. .. The good news is that besides the ever present bad apples there are many people in the world that do respect and value human even more due to there age and wisdom .

[BigRich in reply to Hidden]

Lulu,

I agree with your comments, 100%. I too received an invitation to join Mensa. I bedazzle them, the doctors, with my intellect and by keeping up on the research, I win them over to my side. My daughter, was consulting one of my doctors for medical issue, she had. The doctor said to her. "You know your father could have been a medical doctor."

I am going to try to make 26 years, I believe, I have a good chance to make it.

Lulu, you are making good choices, and I believe you have many years to go on enjoying life.

God Bless,

Rich

[j-o-h-n]

It's like, what's the difference between LOVE and HERPES?

answer: Herpes is forever.

Good Luck and Good Health.

j-o-h-n Saturday 03/10/2018 12:28 PM EST

[BigRich in reply to j-o-h-n]

John,

LOL. that was very funny. I needed a laugh.

Thank you,

Rich

[Hidden]

Herb who? As a teen in the Bay Area during the 70’s we thought herpes was the scourge of the earth. That was until aids hit . Then herb was insignificant in pale. Thanks for the always needed humor!