I previously posted about this scan and wondered about it's value. I had a rising PSA after robotic prostatectomy in April 2016 with a Gleason 4+3+T5 & pT2C, clear margins, appeared organ confined.
PSA climbed continuously since the procedure with current PSA of 0.87 with doubling time of 5 months. Had this whole body scan in Bangkok at the National cyclotron and PET Centre, Chulabhorn Hospital. Results showed "a single PSMA-avid lymph note at right internal iliac node; favour metastatic right internal iliac node".
Meet with uro oncologist and radiation oncologist to review the scan results. Options are various radiation approaches - IMRT to who pelvis with boost to avid lymph node, SBRT to avid lymph node alone & both options either with or without ADT. Case to be reviewed by Hospital Tumor Board next week with recommended options to be advised.
Spoke with second urologist and radiation oncologist where I had surgery with this result. Similar options discussed. SBRT to the avid lymph node seems to be a popular option for oligorecurrent status - with or without ADT.
I am keen to avoid ADT until necessary and research of articles and treatment for oligorecurrent Pca seems to suggest the option of SBRT to the one lymph node is a viable option. I realise there is the potential for other micrometastatic disease to be lurking in other nodes, that were not picked up on the scan.
Any thoughts on this clinical diagnosis and treatment options would be welcome.