New help with what to do next

[bbpj]

New here need some advice. PT3BNO had RP Jul 2018 PSA was .04 six weeks rose to .12 7 months after PP. Had salvage radiation 39 treatments starting in Feb 2019 with six months of ADT starting same time. Some of the lymph nodes where treated first 25 treatments. PSA >.01 Oct 2019 PSA.01 Mar 2020 PSA .04 Aug and now in Oct 28 Psa .11. Have appointment with my Radiation Oncologist Nov 4. Need advice on questions to ask and how to proceed. Have read your post for the past 18 months you are a very knowledgeable and your advice would be greatly appreciated.

[Tall_Allen]

"Some of the lymph nodes were treated first 25 treatments" I don't know what LNs you mean by this. RTOG recently expanded the recommended treatment area up through the common iliac lymph nodes.

[bbpj in reply to Tall_Allen]

Had whole pelvic salvage radiation 39 treatments. First 25 treatments i thought included iliac lymph nodes and last 14 were with boost to just prostate. Was not sure if they could get all iliac nodes because of two hip replacements. He told me he could work around it.

[Tall_Allen in reply to bbpj]

There are many "iliac" lymph nodes - the common iliacs are higher than than the traditional field.

[bbpj in reply to Tall_Allen]

I asked him to do whole pelvic radiation and short term adt. Per article in new prostate cancer link info i assume that what he did. I will email him to tomorrow to make sure.

[Tall_Allen in reply to bbpj]

This is the newly defined field:

redjournal.org/article/S036...

[bbpj in reply to Tall_Allen]

Thank you for the information. Question to you it looks like my salvage radiation failed. What should I do in your opinion if PSA keeps rising, Go on Adt or wait till it gets higher for a pet scan.

[Tall_Allen in reply to bbpj]

You may be able to get an Axumin PET scan when your PSA hits 0.2, but I doubt it will tell you much. Even if it showed something, I don't think there is any difference in the best treatment for you. I'm a fan of hitting it early and hard. Maybe getting in on the following clinical trial:

clinicaltrials.gov/ct2/show...

[bbpj in reply to Tall_Allen]

Thank you sent link to my radiation oncologist.

[Shooter1]

Mine has crept up to 0.12 and I see it as nothing to worry about. Been there before and them back down. Hoping for the same this time. Next month test may should some light on a trend. Not really looking forward to one month results, but onc. thinks we need to watch it closer now. Wish me luck.

[bbpj in reply to Shooter1]

Good luck! Always a little stressful when waiting for PSA result.

[billyboy3]

I agree with TA, hit it early, hit it-actually them HARD.

I am also a proponent of doing a few rounds of IHT, combo. Your psa is very low but less is better when it comes time for war. I also suggest monthly Lupron, say three months in total, with bical daily. Take a psa monthly and when it hits the low point, stop all drugs, and take a break, keep at the monthly psa and stay off cycle until your psa goes back up to 2 to 4. The off cycles give the body time to heal and recover.

Good luck, stay well and live large1!

[bbpj in reply to billyboy3]

Thank you, Vancouver beautiful city have niece that lives there.

[immunity1]

i had similar treatments and responses to you following Dx in 2010, see bio. I would continue now with an GNRH agonist (combined with a AR antagonist or not). When your PSA gets up to 0.3ish I would suggest a PSMA PET scan and Lu177 treatment, if avid, at this 'early' stage, prior to chemo etc. If it is accessible and affordable. Good luck.

[bbpj in reply to immunity1]

Read you bio very similar. Thanks always wanted to visit New Zealand.

[j-o-h-n]

Greetings bbpj,

Sorry to do this but it helps us all...

Please tell us your bio. Age? Location? Treatment(s)? Treatment center(s)? Scores Psa/Gleason? Medications? Doctor's name(s)? Thank You!!!

All info is voluntary, but it helps us help you and helps us too. If you do respond copy and paste it in your home page for your use and for other members’ reference.

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 11/02/2020 6:09 PM DST

[bbpj]

Will give quick bio have some saved on bio page. 64 years old still working Plant superintendent at D&L Foundry Moses Lake Wa . Moses Lake is a town of over 20000 in central Wa 2.5 hours from Seattle and 1.5 hours from Spokane Wa. Was Diagnosed March 2108 PSA 15.8 TC2 3+4 gleason score 7. Had robotic surgery July 2018 at CWU hospital in Wenatchee Wa part of Confluence Health after surgery upgraded to 4+3 gleason 7 PT3BNO positive margin svi identified 50% prostate with tumor. First PSA in six weeks .04 12 weeks .03 18 weeks .1 tested two weeks later .11. Had salvage radiation starting in Feb 2019 39 imrt whole pelvic and prostate and six month shot of lupron started the same day. Radiation done in Wenatchee Wa Confluence health the cancer center is part of Seattle Cancer Care Alliance. First PSA six months after radiation <.01 12 months .01 18 months .04 and now is at .11 Oct 28. I take a statin and lisinopril the only medication that taking as of now. Dr. Ian Mclaren urologist and surgeon. Dr. Thomas Carlson Radiation Oncologist. Have appt, with Dr Carlson tomorrow.

[j-o-h-n in reply to bbpj]

Thank you for your bio and it's good that you added it to your home page.

Keep posting.....

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 11/07/2020 2:50 PM EST