My RO has suggested I might wish to consider an ADT holiday and then, when PSA reaches a sufficient level (1.7?), doing an axumin scan. If there are no bone or non-lymph visceral mets, then radiate the pelvic lymph nodes. This was in response to my question about maybe just radiating them now.
I will be talking with other ROS, and I have read the post by Tall Allen stating “the benefit of salvage whole pelvic treatment and ADT was not maintained in men with very low PSA” and the related study.
History: PSA 5.3, RP 2009 Gleason 3+4, Biochemical failure PSA 0.66 and SRT 2012–no benefit, Radboud nano-iron MRI July 2014 nine lymph nodes 4-9 mm in left para-aortic and common iliac, PSA 2.77, Feb/Mar 2015 IMRT and 4 months degarelix–PSA reached undetectable, degarelix wore off in Oct. 2015, PSA 3.64 and resumed degarelix Dec 2016, PSA 0.02 June 2017 and every time thereafter, switched to lupron Aug 2018.
What do you all think about this plan?