Lymph Node Methasizes

[Toad1]

My lymph node methasizes, which used to be confined to my pelvic area, suddenly have exploded and gone all over the place.

Does anyone know any treatment that specifically targets lymph node methasizes?

[Christopherg]

Good morning

So very sore to hear of the spread to lymph nodes

If you don’t mind me asking which lymph nodes apart from pelvic area?

Best wishes

Christopher

[Toad1 in reply to Christopherg]

Too many to list but many different areas.

[Tall_Allen]

Systemic therapies are best, even though they don't only target lymph nodes.

[tango65]

If the cancer is PSMA positive you could get treated with Lutetium 177 PSMA in Europe and Australia. I had lymph node metastases in the pelvis and abdomen. I went to Munich and I got treated with LU 177 PSMA. After one treatment the metastases were cleared according to a Ga 68 PSMA study done 5 weeks after the first treatment.

You could start androgen deprivation therapy and take your time to search if you could get treated with Lu 177 PSMA.

[George71 in reply to tango65]

Can I ask, How long ago did you get Lu-177 - what does it cost? And did it kill all the cancer? What was your PSA at the time?

[tango65 in reply to George71]

I got the treatment in September 2016. My PSA was 10 when the lymph node metastases were diagnosed with a Ga 68 PSMA PET/CT study in August 2016.

I started ADT immediately . When I went to Munich my PSA had dropped to 0.8 so the doctors in Munich requested another Ga68 PSMA PET/CT study which showed the same metastases than the study done in August so they decided to proceed with the Lu 177 treatment. The cost of the treatment is around 9K euros . If a Ga68 PSMA study is required it will add 3K euros.

[cancervictim in reply to tango65]

It's been 2 years since your treatment. Is your PSA still zero? If you develop other mets, will you or can you get Lu 177 treatment a second time? Thanks for sharing your experience.

[tango65 in reply to cancervictim]

The PSA is 0.06. The cancer is becoming castration resistance. I could get a Ga68 PSMA study when the PSA is around 0.4. If there are metastases I could choose to get treated with Lu 177 again instead of chemo or enzalutamide which have more side effects. The Lu 177 is a systemic therapy , the same than chemo or enzalutamide. If the Lu 177 fails I could start the other therapies.

[cancervictim in reply to tango65]

Thanks for your response. I don't suppose a lot is known about repeated treatments like this? How did you or they decide that one treatment was enough? Maybe if your PSA had not responded so well they would have done a second treatment? I'm very happy to read of your outcome.

[tango65 in reply to cancervictim]

After the first treatment (3 days after the Lu 177 infusion) they did a body scan and a SPECT scan to see where the Lu 177 was located in my body and I believe for dosimetry studies. They could not see Lu 177 in the areas where the metastases were according to the Ga 68 PSMA done the day before the treatment.

They requested I had another Ga 68 PSMA PET/CT which was done 5 weeks after the initial treatment. This study showed that the affected lymph nodes were clean of cancer ( PSMA negative), so the doctors in Munich decided to stop the second treatment.

I did not had metastases anywhere according to this study. They do not treat if the cancer can not be visualized with a Ga 68 PSMA PET/CT or similar PSMA study. They treat until the metastases are gone or a maximum of 4 or 6 treatments is reached. I believe the total number of treatments will be determined by the results of the dosimetry studies.

[Christopherg in reply to tango65]

Please advise which hospital you went to in Germany?

Thank you for sharing your great outcome

Best wishes

Christopher

[tango65 in reply to Christopherg]

I went to the Technical University of Munich. The hospital is called Klinikum rechts der Isar.

[Christopherg in reply to tango65]

Thank you so much

All best wishes to you

[JanJames in reply to tango65]

can you give me some more info on your LU-177 treatment. Which hospital in Munich and how did you arrange it etc

[tango65 in reply to JanJames]

I went to the Technical University of Munich. The hospital is called Klinikum rechts der Isar. I arranged directly with the doctors and the hospital administration.

[Ian54 in reply to tango65]

Interested in an update. Just had Psma Pet showing pelvic lymph node involvement psa 0.9. Had Brachytherapy, salvage Rp. Now considering Lu-177 at London Clinic.

Has there been any further recurrence. Seems like also chasing it, want to get ahead of it. Regards Ian54

[Lynsi13]

Which treatments have you already had? My dad had chemo and it destroyed the cancer in his lymph node.

[Toad1]

Sadly, Taxatore did nothing for me.

[GAdrummer in reply to Toad1]

It is frustrating when node only men are excluded from treatments because they aren't sick enough, especially when all other standard treatments have failed. My husband's MO finally gave up on Docetaxel and switched to Cabazitaxel this week. It is making my husband much more miserable as it is taking twice as long to progress from constipation to needing to take Immodium. He seems totally wiped out (or depressed), and refusing to eat or get out of bed .

[Patrick-Turner]

Lu177 Theranostic treatment is probably best. But the mets should all be able to be seen on PsMa scan which can only display mets which are producing PsMa. The Psa and PsMa are two different but related chemicals produced by Pca tumours. The docs might also start you on ADT unless you are already on ADT, which stops your balls making testosterone, ie, chemical castration.

My Pca history shows that Pca spreads even while suppressed by ADT, Cosadex, Zytiga.

The spread was far slower than if ADT had not been applied.

The spread probably occurred while the original Pca site at prostate gland was growing into a Gleason 9+9 monster all before my yearly Psa test gave a result of 6.0.

So I had a lot of cancer which made a small amount of Psa.

Thus I was diagnosed in 2009, about 4 years too late.

My cancer probably began in 2004-5 when Psa was below 3.5.

All scans have the problem that they cannot see small mets below a certain size. So this means a man thinks he has no mets when in fact he might have hundreds if not thousands, and then when they reach a detectable size, they all begin to show up on scans.

If a CT scan shows mets which are not on PsMA scan results, it may mean you have mets which have mutated and do not produce PsMa, and these will not respond to Lu177 treatment. These may need chemo, or if in bones, maybe Ra223.

There is NO TIME for you to dither about; you must seek treatment ASAP.