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Advanced Prostate Cancer
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Radical Prostatectomy with Bone Metastases

Hello, gentlemen. Thank you so much for your latest replies to our previous post.

My husband is being treated at Johns Hopkins for T4 PC, bone mets, 45 years old. I was wondering, with the latest studies on radical prostatectomy in metastatic patients gaining popularity... has anyone had any experience with that? Any feedback is GREATLY appreciated. Keep fighting, handsome warriors. I am thankful for each and every one of you.

Here's the link to one of the articles: ncbi.nlm.nih.gov/pubmed/297...

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Here are some articles covering other studies about the benefit of treating the prostate after distant mets have been discovered. I wish the data were more conclusive, but they certainly do SUGGEST a benefit:



If it is T4 (spread to adjacent organs), why would you choose surgery (which can't extirpate the cancer that has spread there), over radiation (which can)?


True. Thank you! I was just interested in finding out more about it. Radiation certainly sounds more beneficial. My understanding is such that after they perform the cytoreductive surgery, they proceed to radiate the nearby metastatic sites and still offer systemic therapy, in addition to all of that.

Here are some articles I found:






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One should NEVER go into surgery thinking that it will be followed by radiation. The side effects are cumulative - radiation on top of surgery can have really bad side effects - if one has to, one has to - but one should never be cavalier about it.

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Not candidate for radiation. Had RP that left spiderweb of gleason 9/10 in perineural and vascular bundles in all margins leaving prostate. Spreading to lymph nodes and unrelated tissues on posterior rectal plane. No target for radiation without extensive damage to surrounding structures.

Started ADT and chemo. Got PSA down to 0.140 from 64 before treatments and 54 before RP. Oddly enough, I had enough diverse Pca with spiderweb throughout abdominal and pelvic area PSA actually went up in the 6 weeks following surgery. Not Good, but all treatments seem to be working. On Xtandi and off Lupron. (Opted for orchiectomy rather than ADT drugs for life).

Awaiting scans (bone,abdominal,pelvic) first part of next month. Last scan had 2 new lymph nodes and three bone Mets. Hope 9 cycles of chemo nailed them.

That my experience with RP with mets. Good luck with yours.


Add: Just got blood results from Dr's appt. 2 days ago. Best overall since last Sept. PSA still stable at 0.137. Liver enzymes and such better than before diagnosis with Pca. Guess chemo did it's job. Now wait and see for the next ten years.


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