Radiation Recommendation for Met Spots

Hello fellow warriors, I would like your thoughts on radiating metastatic spots on my bones. I just had my latest 6 month scans and the Lupron plus Cassodex has my PSA coming down to .56 and only 2 of my Met spots seem to have any activity since my last scan 6 months ago. Good News.. One spot is very accessible on my right iliac wing hip bone. It actually now is beginning to hurt a little bit. Have any of you had any success in "shooting" a spot??? What method did you use??

Thanks always for your input and keep fighting.

Tom

[Timfc]

I had a single dose of SBRT to a lesion on my spine (T8) at the Mayo clinic in March 2018. I have been on ADT since February 2018. At this point PSA is undetectable. I have had no further scans, but they wouldn't likely show anything at this PSA level. Backing up in my story, when I was first diagnosed PSA was 26 and Gleason 4+4. Surgery failed after 9 months, then IMRT failed after another 9 months.

Anyway, I really dont know if the SBRT actually worked on my T8 tumor, but I hope it did.

[Hidden in reply to Timfc]

Thanks Tim

Your story is almost identical to mine - 2002 RP - 2003 Radiation - PSA came back in 2012 - took just Cassodex until January of this year - now Lupron plus Cassodex.

Which Mayo did you go to??? I go to Mayo Phoenix.

Thanks,

Tom

[Timfc in reply to Hidden]

Mayo in Rochester. I was trying to get in with Dr. Eugene Kwan but was diverted into radiation oncology. I am currently becoming disenchanted with my doctor (a urologist), as Iam not sure he is offering me all the options.

[Hidden in reply to Timfc]

I also have a spot on my L3 vertebrae that still has some activity. I did not know they could shoot it too.

I know the feeling about my MO. Our only hope is Mayo has the tools to stay up on the research.

Dr Kwan's videos are VERY convincing on SBRT.

I am seeing my MO on Thursday. So you don't know if the SBRT worked on your T8. You said you have not had a scan since 2018. Even with less than .1 - that seems unusual - I get the scans every 6 months at Mayo Phoenix. Maybe you should go to a MO in Rochester. I hear they are the best in the Mayo system.

Keep the faith.

Tom

[Timfc in reply to Hidden]

My PSA at the time of my PSMA scan (at UCLA) was 2.4. It had rebounded 9 months after my IMRT, and within about 4 months of the start of rebound it was up to 2.4.

[Hidden in reply to Timfc]

Thanks Tim

[Hidden in reply to Hidden]

Hey Tom, please forgive me if I’ve told you about Dr P. Singh at Scottsdale mayo. He is the pc specialist that made the right moves for me.. Is there anyway that you can speak to him ? I’ve seen many of guys over the years zapping Metzs with good results .I think I’d do it for sure and not look back ... peace

[Hidden in reply to Hidden]

Hi Whimpy:

I am currently going to Dr. Brice at Phoenix Mayo. I see him tomorrow.

If he does not agree to do SBRT on this met I will try to see Dr. P. Singh.

Not sure Singh will see me if I am a Brice patient.

I will keep you posted.

Keep ducking and swinging at the monster.

Thanks,

TC

[Hidden in reply to Hidden]

I wish that I could still see Singh but I’m on Medicare Medicaid acchcs , mayo tells me it’s illegal for a Medicaid patient to be seen in mayo even is self pay..I’m in clear status now and they’re not doing anything to me presently. Take you pills. That’s it ! I personally think mayo is quality care. You’re in good hands.. Be well ..

[Hidden in reply to Hidden]

Thanks Whimpy

[Hidden in reply to Hidden]

Good luck in finding your fix.🙏

[Tall_Allen]

SBRT in a single dose of at least 18 Gy seems to provide excellent local control:

pcnrv.blogspot.com/2019/08/...

[Hidden in reply to Tall_Allen]

Thanks so much TA

[MarkBC in reply to Tall_Allen]

As I read this blog post, it seems that spot radiation is only useful for pain relief. It says patients should not expect any increase in survival time. So this means there would be no benefit to hitting a bone met that is growing but not causing pain. Correct?

[Schwah in reply to MarkBC]

Many experts in the field believe that SBRT to mets the in men with less than 5 mets, may extend survival. No proof yet but there clinical studies ongoing. The theory as I understand it is related to the abscopal affect.

Schwah

[Tall_Allen in reply to MarkBC]

Correct. There is no known relationship between treating metastases and survival. There seems to be at least a short term slowing of progression, but no one knows whether that will eventuate into longer survival.

pcnrv.blogspot.com/2019/09/...

Clinical trials are exploring this. There is a list of them at the end of this article:

pcnrv.blogspot.com/2017/07/...

[Hidden in reply to Tall_Allen]

Thanks TA

[Hidden in reply to Hidden]

No undervalue pain relief . QOL

[Hidden in reply to MarkBC]

Thanks Mark. I do have some pain too.

[ctflatlander]

TC, I'm 76 Oligo, Gleason 4+4 PSA 34 and had mets T3,T4. After 1 year on double ADT my lowest PSA was .7 Did IMRT and while PSA was climbing(bounce) did SBRT 2 mos later to the bone. PSA now undetectable for 6 mos. I say go for it! Bob

[Hidden]

CT - you are the best!!!!!

Did you get SBRT Single Dose like recommended by TA?

I am going for it and if my MO at Mayo won't do it I will find someone who will.

Thanks - TC