anastomosis Treatments choices

[Ahk1]

for those who are not familiar with the term anastomosis, it’s where the surgeon attaches the urethra to the bladder during prostate removal. They found a 10 mm lesion on that spot on me and I am planned to do a biopsy to confirm the PC. I would appreciate anyone who had similar experiences with This. One RO recommends SBRT to that spot ( I had IMRT) to the prostate bed 2 years ago so I am worried of radiation again. Another RO looking into the possibilities of freezing it. You am very nervous about which one I should do

Thanks

[Ahk1]

Thanks, Nal. I appreciate it

[Tall_Allen]

That's the most common site of recurrence because of the cancer from the prostate left behind there. Having had IMRT there already, I'd be a little wary of more radiation this soon, but if the SRT was on the low end (~66 Gy) the urethral tissue may be able to tolerate some more brachytherapy or SBRT. Cryo may cause even more damage to the urethra. This is the kind of thing you'd want very expert practitioners for.

[Ahk1 in reply to Tall_Allen]

Thanks, TA. I have the top Dr at MSK looking into it and who is the one suggested SBRT ( 5 sessions). Do you think ADT alone can shrink it and I forget about the radiation?

[Tall_Allen in reply to Ahk1]

I think you have to talk to a radiation oncologist, like Michael Zelefsky at MSK. Jonathan Coleman at MSK should be able to advise about focal ablation. They have to look at your treatment plan from your previous SRT and your exact anatomical situation. Hormone therapy will shrink it, but will not get rid of it permanently.

[Ahk1 in reply to Tall_Allen]

Thanks, TA. DR Zelfesky is the one who told me that he will do SBRT, 5 sessions. Do you think I still need to talk to Dr. Coleman?what is focal ablation mean?

[Tall_Allen in reply to Ahk1]

Maybe you can set up an appt for the same day.

[Ahk1 in reply to Tall_Allen]

Thanks, Allen. I read about it

[tango65]

If it is confirmed that the lesion is PC, get a third opinion from a different RO. UCSF (Dr. Roach), UCLA (Dr. King), Dana Farber (Dr. D'Amico) etc have good radiation oncologists specialized in prostate cancer.