Last week, there was an open question about the precisely targeted treatment of recurrent pelvic lymph nodes at the Mayo Clinic. This European study suggests that patients did better with whole pelvic salvage.
Thank you. I appreciate greatly your support to all the participants on here. You are an incredible resource. Thank you for all you give of yourself to this community....and best wishes for a great 2021!I am schedule for pelvic RT in 2021....your post feels like a holiday gift
Thank you so much TA for posting this and for your hard work following these complicated issues which most professional DR’s have a hard time answering them. The questions that has not been answered in the trials, as you mentioned them in your article, are what makes me hesitant now to pursue radiation in general in my case. Happy holidays.
I suspect that future RCTs will only show a benefit if there are very few small metastases in pelvic lymph nodes only, and whole pelvic treatment and long-term ADT is given. Otherwise, life-long ADT (the current SOC), perhaps augmented with second-line hormonals, will certainly prolong life and quality of life.
Oligometastatic is usually defined as 1-5 detected by a bone scan/CT. With the newer PET scans, there are many metastases smaller than the 1 cm limit used for CT or MRI. In the ORIOLE trial, there was no advantage when more metastases were detected on a PSMA PET than showed up on a bone scan. And in this European study, neither radiation technique had an advantage if there was more than 1 LN met on a C-11 Choline PET - perhaps that suggests no MDT advantage for more than 1 met, perhaps not.
Tall_Allen's opinions, posts and replies always matter to me. As does the opinions of many of the other posters here. Except j-o-h-n. I was sure I wrote rosetta on that stone I threw through your front window.
Holy Taylor Swift Bat-j-o-h-n!!!*%# Did you see the mouth on that gal? I'm ordering my Oculus today. We could all use a little reality. Some more than others. Excuse me now, I need to go clean off my front porch.
TA - in your blog I think you meant ‘PSMA” in the sentence ‘metastases smaller than 4 mm, and those that put out only small amounts of PSA remain invisible.’
When i had a 3 spot cancer cells in my LymphNodes ,i asked my oncology Dr.Weise from Germany about to treat the 3 spots ,he told me we will irridate not only the 3 spots all the area surrounding .Ofcourse he showed me the spot on his computer and how will treat it.
Very good Dr.
Merry christmas to you and to all members of HealthUnlocked.
This study suggests that it is better to treat all pelvic LNs than just the cancerous ones with an area around them. Some top ROs treat as high as the lymph nodes at the aortic bifurcation.
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