psma scan confirmed cancer in prostate, along with 4 to 5 pelvic lymph nodes.
Up until the results of this scan today, we were told surgery was not an option.
We are being advised by RO and Dr at UCLA to do radiation to prostate and nodes. Brachy boost is not an option because prostate is 130g.
We now appear to be suitable for surgery too, although it won’t suffice on its on. Additional radiation and adt will be required.
So far 2 years of adt proposed as adjuvant therapy to radiation and or surgery.
Anybody who has an opinion about this is welcome to reply. You are all wonderful and I feel grateful to have this place to come for information and support.
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Dachshundlove
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We saw Dr.Rettig. We have not seen Chris King, yet. The RO who was available yesterday said due to prostate size, we had to do external type radiation and a long course, 9 weeks.
It sounds like his particular situation is difficult to treat with radiation.
Yes, that is what he said. Prostate too big and Brachy would carry additional risk and not treat the problem.
It seems that due to the enlarged prostate we are in a less than ideal treatment scenario. Not great news. It also seems like maybe in our case (prostate extra large) surgery is more likely to successfully deal with primary tumors.
We now officially have more questions than answers.
He is right that side effects are worse with a larger prostate. The solution is to shrink the prostate. In the ASCENDE-RT trial, they shrunk everyone's prostate with 6 months of hormone therapy before brachy boost therapy. Ask Kishan if he would consider brachy boost with 6 months of "neoadjuvant ADT"?
I do not know Rettig but kishan is awesome. Tall Allen our resident guru on all things PC also speaks very highly of kishan. Really nice guy too. He’s returned emails from me late at night.
This sounds correct about BBT. Usually the cutoff size of the prostate is about 60 ml because a large prostate often overlaps with the pubic arch, which interferes with needle placement. Also, radiation coverage may be an issue with a large prostate, requiring very long dwell times I just had HDR-BT there-- my prostate was 30ml and they placed 19 catheters.
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Favorable Ga-PSMA scan results at UCLA !!
Surgery or radiation, looking for some advices 
Surgery or Radiation?
Is surgery, radiation or Lu-177 therapy appropriate for my case? 
Sabre radiation or Surgery for node positive removal?
