Lymph-node tumor

[beatPC]

So my MRI showed no bone mets. So my fight is focused on a lymph-node tumor for now. Wanted to ask: In your experience are these tumors removed in CRPC? If not, why not.

[Tall_Allen]

Where is it? If it's part of the prostate drainage in the pelvis (N1), treating the entire area might be curative. If it's outside of the pelvis (M1a), it has traveled there systemically, and there may be little if any advantage in treating it. Also, safety is an issue for many locations.

[beatPC in reply to Tall_Allen]

thanks. 4 were removed on either side during my prostatectomy.

[Tall_Allen in reply to beatPC]

That tells you nothing.

[beatPC in reply to Tall_Allen]

oh. and it is not outside the pelvis (missed that on the first read).

[beatPC in reply to beatPC]

the ca hadn’t spread there at that time.

[beatPC in reply to beatPC]

also my second opinion onco recommended provenge, but do it sooner rather than later

[Longterm101 in reply to Tall_Allen]

How do RO accurately target local lymph nodes. Seems like shooting blind. I’d be curious ur thoughts

[Tall_Allen in reply to Longterm101]

They do a CT scan - not blind at all

[Longterm101 in reply to Tall_Allen]

Understood however many RO like to use fiduciary markers for the prostate so it can be tracked during trace movement

With lymph nodes being so small and slight movement surely occurs during treatment I always wonder how they can hit their target

Insight?

[Tall_Allen in reply to Longterm101]

They use cone beam CT and/or stereoscopic X-rays before treatments. They site on bone or soft tissue landmarks. Intrafractional targeting is unnecessary with 1.8 or 2.0 Gy per fraction.

[Longterm101 in reply to Tall_Allen]

Over my head but thank u TA

[tallguy2]

Depends on location. Lymphodema can be an issue if too many are removed. I had my two metastatic lymph nodes and the surrounding area irradiated.

[NPfisherman]

You were diagnosed with a retroperitoneal mass, correct? Why are they not looking at radiation and it is unclear what type of scan you had?

Fish

[beatPC in reply to NPfisherman]

I had bone scan & ct scan. i believe it’s because of the location/position of the tumor.

[beatPC]

CT bone and MRI. radiation is one of the treatments my onco is looking into

[NPfisherman in reply to beatPC]

So it was not Axumin or PSMA scan. correct?? If they can do stereotactic radiation to the retroperitoneal mass, that could wipe that out, but are they also considering any other treatment like adjuvant radiation ?

Fish

[beatPC in reply to NPfisherman]

radiation is being considered. virtually everything is on the table. will see my onco in a week. by then we should be making a decision. thanks

[NPfisherman in reply to beatPC]

Good luck, brother...

Fish

[beatPC in reply to NPfisherman]

thanks

[Hidden]

The sum total of my understanding. Micro-metstatasis. The unseen little bastards that travel the vascular and lymphatic systems looking for a place to colonize and multiple resulting in metastatic lesions.

Most look for the offending area and then radiate or remove. I favored early and aggressive systemic treatment. It worked for me 15 years ago. How can one tell if it works: repeated nuclear bone scans and soft tissue CT scans with undetectable PSAs. I guess the new and improved scans are better, but I have no experience with them.

GD

[beatPC in reply to Hidden]

thanks