Hi all - would welcome advice on next steps. 49 y/o Diagnosed with prostate cancer in July with uptake on lymph nodes and 3 bone lesions smaller than 2cm on each hip and on t3 and PSA of 4. Biopsy showed all 10 cores positive, Gleason scores of 7, 8, and 9. Started on Zoladex and Casodex in July, and oncologist added Zytiga in September. PSA dropped August .8, September .5, October .08, November .02, December .01.
Did PSMA pet scan in October and aggressive oncologist advised disease is "Oligometastatic." Did 4 rounds of Taxotere chemo at .75. and then offered option between brachytherapy and prostatectomy based on "obvious shrinking of tumor on DRE" and "response to systemic therapy."
Just had DaVinci prostatectomy and received pathology report - they wrote "focal intraductal carcinoma suggested" but apparently the good news is "negative margins". They also took out 25 lymph nodes and 0 came back positive. No seminal vesicle invasion and no bladder neck invasion.
The pathology was ypT3a N0.
The oncology team is now suggesting that I consider radiation to the prostate bed and SBRT to the bone lesions. I wonder if anyone else has had a similar journey. I am a little confused because they doctors seemed very grim upon diagnosis but are now more encouraging and suggesting that radiating is the best course of action.
Thank you for any advice or suggestions!
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