Hi all, I'm new here...I'm 56 and was diagnosed in February with metastatic PC. My GS was 8-9 for all 12 cores. Cancer spread to lymph nodes, I also have lesions in the T4 and T9 vertebrae and multiple very small lesions in other parts of spine, lumbar and iiliac bone. The tumor in the T4 vertebrae caused a fracture, so I had kyphoplasty last month. I started firmagon two months ago and Zytiga a month ago. My MO and radiologist suggested I now start radiation treatment of the prostate. I am undecided if I
should start the radiation. Is this common practice for advanced
prostate cancer? Radiologist pointed out a recent study
(STAMPEDE, 2018) which showed no benefit for high metastatic burden patients (four or more bone metastases with one or more outside the vertebral bodies or pelvis, or visceral metastases, or both). For low metastatic burden patients (fewer than 3 bone metastases and absence of visceral metastases) there was a benefit and improved overall survival from 73% to 81% at 3 years (not that great). The radiologist said I am low burden, but I think I may be borderline (low/high). I don't want to go through the radiation and possible side effects if it will not provide any benefit. I have an appointment next week to start radiation and leaning towards going through with it. Does anyone have any feedback on this and on possible side effects from radiation?
I did chemo, HDR Brachy thereapy, and direct beam. Also was on Zytiga and currently on Lupron. Difficult to sort out what did what, but as far as I can tell, the radiation irritated my bladder slightly. I believe radiation was the least of my worries. Putting myself in your shoes, I would opt to follow the doctor's recommendations.
Thank you for the response. I'm still trying to decide.