Options after Zytiga-IGRT

[db1966]

Hi All,

I was diagnosed in Dec 15 aged 50 with a 212 PSA.(stage iv gleason7) Had chemo with lupron every 3 months which reduced my PSA to 0.1 for 2 years and crept up. Been on Zytiga/Lupron and prednisone ever since and PSA has crept up again from an average of 0.1 to 0.8 past 6 months. Recent Axumin PET scan showed that lesions had disappeared from spine and ribs but one remains in the pubic bone that caused some discomfort if i over extend on the squad courts (right now it has settled down)

My MD wants to do IGRT on the lesion and also the prostate and lymph nodes surrounding this area. approx 8 weeks and daily.

My care has been with Kaiser in California and to be fair they have been brilliant through the past 4 years.

I am appreciate of the care I have had and glad still to be here with my wife and family.

My concern is if this is too early for IGRT as I feel great and not really experiencing pain too often at all. The MD opinion is to 'bank' drug options for later when I need them and lets take a radical approach to suppress the C.

My concern is the side affects of IGRT-Any recent experiences greatly appreciated.

Regards

Pat

[Tall_Allen]

The option he is talking about is sometimes called "debulking." It only works if there are very few metastases:

pcnrv.blogspot.com/2018/09/...

I've spoken to some oncologists who prefer to "debulk" the prostate even if there is no oncological benefit. They feel it prevents later problems caused by the cancer blocking the urinary system.

[db1966 in reply to Tall_Allen]

Thanks Tall Allen. Very helpful.

[db1966]

Thank you Nalakrats. None of my MD’s are a fan of removing the prostate with there position being that the cancer has already got out so what’s the point!! To radiate it now kind of makes sense but of course the damage to other organs is a risk but maybe worth considering.

[db1966]

So even 4 years after diagnosis your opinion is that I should discuss further with my MD to consider removal of the prostate? I think I will do that. Thank you sir. I needed someone to challenge me on this.

[db1966]

I’m in Southern California with Kaiser

[Tall_Allen]

Who is your RO?

[db1966 in reply to Tall_Allen]

Dr Kim at kaiser in Anaheim he is working with Dr Ahmed at Kaiser My regular oncologist.

[Tall_Allen in reply to db1966]

I haven't met him. I'm familiar with some in LA- Goy and Cosmatos.

[j-o-h-n]

Challenge your docs....it's your life......

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 12/08/2019 9:28 PM EST