Is a delayed recurrence post RP more indicative of metastatic cancer than a curable local recurrence?

[Gemlin_]

Then salvage therapy for BCR in the late period, 5 -10 years, would be less successful (or even futile) than salvage therapy when BCR occurs in early period, 1 - 5 years. Has anyone seen statistics on this?

[pjoshea13]

My RP was unsuccessful & I asked a similar question. Unlike RP, salvage radiation [SR] isn't performed with curative intent, but what was the probability that that cancer was still local?

The imaging of the time (15 years ago) wasn't so good, but the SR was contingent on there being no visible bone mets. There were none, so I had the SR - which also failed immediately. Two failed procedures, but as I'm still here, maybe they weren't really failures?

In your case, there is now much better imaging. If nothing shows up, assume that the cancer is local. Imaging is better than statistics.

-Patrick

[tango65]

You should try to get a Ga 68 PSMA pet/CT or a 18F DCFPyl PET/CT to determine where the metastases are located. Only metastases 3.5-4 mm or larger will be shown. These tests have a significant higher detection rate than CT scans or bone scans. There are clinical trials for these tests:

clinicaltrials.gov/ct2/resu...

clinicaltrials.gov/ct2/resu...

If the cancer is still located in the pelvis whole pelvis radiation , with treatment of lymph nodes up to the bifurcation of the aorta and short term ADT has been proven to offer the best progression free survival.

astro.org/News-and-Publicat...

[Tall_Allen]

Later recurrence is more curable by SRT than earlier recurrence in this nomogram:

mskcc.org/nomograms/prostat...