where is the cancer/which path to take?

[Ahk1]

Hello,

Quick update:

Done MRI and PSMA at NIH 2 months ago. MRI found 10mm lesion(where surgeon sewed bladder to urethra) and 4 mm at hip. PSMA found nothing. dr suggested biopsy to the urethra/bladder. The biopsy came back negative for cancer(scar tissue). By the way this what TA suggested. Psa now is .63 as of 2 months ago. RO suggestion was if the biopsy comes back positive then he will do SBRT to both sites without doing biopsy on the hip

Now, the biopsy is negative, should I radiate the hip without a biopsy on the hope the psa is coming from there? It’s only 4 mm to biopsy plus it might not even be cancerous

Not sure what to do and what treatments is optimum.

Any thoughts would be very much appreciated

[Ahk1]

Thanks, Nal.

I am not sure about the hip lesion being positive or negative. We didn’t biopsy that one. The RO said, let’s wait untill the biopsy of the bladder/urethra results come, if it’s positive then he will radiate the hip lesion without biopsing it to find out.

I have never been on ADT and only take IP6 whenever I remember every few days or so.

[Ahk1]

Yes, this is the one I take. Thanks

[Tall_Allen]

If you have a 4 mm lesion on your hip, the best way to see if it is a metastasis is to go on iADT - if it shrinks, it's a met. if it doesn't it's not.

[Ahk1 in reply to Tall_Allen]

Thanks, TA. I appreciate your thoughts.

[Ahk1 in reply to Tall_Allen]

TA, what do you think of the idea of treating the lesion with SBRT WITHOUT confirming it’s a cancer or not? Would the damage or side effects from the treatments be more than IADT?

[Tall_Allen in reply to Ahk1]

Since there is no known benefit to doing that, and you know your PC is systemic, a systemic treatment makes more sense to me.

[Ahk1 in reply to Tall_Allen]

Thank you. I understand. May be that is why Dr. Morris suggested that since last year. It’s very hard to have a grip on these things.