" 31.9% were bio-chemically Disease Free (bDFS) at 15 mo. ! ! ! ! !
All patients with Bio-chemical Failure (BF) (n=43 - out of 57) underwent a repeat PSMA-PET scan, which revealed no in-field failures. ! ! ! ! !
Median bDFS was not affected by prostate-specific antigen (PSA) at diagnosis, Gleason score, time from diagnosis to SBRT, site (bone vs LN), PSA doubling time before SBRT, or number of metastases. ! ! ! ! !
Failures were somewhat less common in patients with low PSA before SBRT. Toxicity was rare: no patients developed grade ≥2 late toxicity."
Bottom line for me is: --
(A) even after metastasis occurred -- apparently one third were cured with SBRT alone (no ADT to skew the results) and
(B) all of the remaining two thirds were cured in the treated areas, and
(C) SBRT ends it in that area -- unlike ADT alone that does not cure anyone and causes cancer to become drug resistant 80% of the time.
(D) even though it reoccurred in other areas it could be treated there with SBRT as well.
I had sbrt for oligomets to bones twice. I had biochemical recurrence within a couple months but of course elsewhere. So those mets were killed but others became visible . Not surprising since there are millions in your system.
I agreed with your comments. Most of the patients could delay ADT for more than 1 year. It is a good thing to delay the trip to castration resistant and highly mutated cancer which is impossible to stop.
Thanks for posting, George....I believe in Stereotactic Radiation and had my oligometastatic lesion treated....I believe the Phase 2 results will be positive and on to Phase 3... Have a great day....
I’m a g-9 who has been on IHT for 10 years. I get a f18 pet/ct fairly often and when PSA becomes detectable and something shows on scan I radiate those spots and go on some form of HT. My time off HT (with normal testosterone) has been about 3 years two different times. I can’t prove it, but I think zapping those spots adds time to my HT vacation.
George - I had surgery and adj radiation in 2009. About 15 months later PSA began to rise and spots were seen on traditional scans...that’s when I started IHT and spot radiation.
I'm thinking about whether to -- radiate the prostate bed and surrounding pelvic lymph nodes, or wait and spot weld when they show up on imaging.
Meanwhile I was considering stopping the Avadart and going on continuous super high dose Testosterone for the double strand break.
your thoughts ?
I had surgery 4/2016 --
90 day post pathology found neg. margins -- PCa in 4 of 10 lymph nodes 0.03 PSA -
so far no other treatment but diet/supplements / vitamin D3 - K2 /Dukoral/Doxycycline w vitamin C and started Avadart 9/2017 when PSA reached 0.6 see below.
Recently, a post on a new laser to zap CTC's is being brought to trial... I do wonder if combining the 2 might get people 15 years or more... Not sure if you are aware of the new laser treatment....
As I recall, the article said they zapped what they believed to be about 96% of CTC's in 8 hours....that should add a few years of life I am thinking....
That sounds great, I wonder when it will be broadly available -- everyone should do it regularly. who knows that may stop virtually all new mets from occurring.
Medical devices usually take only 18 months---2 years...unlike the lengthy medication approval--Phase 3/4 testing---we might see this soon....I believe they have an expedited version as well--1 year---Exciting stuff !!!!
There is testing involved....but it doesn't go through the same lengthy process....like I say, if this is the real deal, we can get it likely within 2 years or less....
You keep knocking them off when they pop up till they are all gone. I think that is a great strategy. Also, it may be that you kill off the PCa before they can become CRPC.
I was recently treated to my mets with stereotatic radiation that had been found with PSMA. My goal is to delay ADT and I believe it will help. For a long time there were those who preached it would do no good but now it is becoming accepted. With the advent of more sensitive imaging more focal and precise treatments are possible.
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18F-DCFPyL PSMA PET/CT Scan Result
Stereotactic ablative radiotherapy for new recurrent prostate cancer nodule. 
