Types of radiation. Which is best for pelvic bone mets?

[baltha]

I have 3 pelvic/femur hot spots on my recent MRI and and am experiencing some hip and thigh pains; not bone pain per se but muscles/ligaments/fascia/nerves which could be related to the presence of cancer. The pains followed a bone biopsy (through the buttocks to the Ischial Tuberosity.) Ouch.

Anyhow, I am looking at radiation of the mets. Brachytherapy makes me nervous as it requires perfect execution it seems, and so that leaves ERBT which seems to have a few flavors including Proton. Any thoughts or experiences you could share would be much appreciated?

My history: I am stage 4 mCRPC and have, over 2 years, done Docetaxel and Lupron with modest success and Abiraterone with no success. PSA 8. Pelvic area bone mets only; no visceral mets observed, no lymph nodes.

With appreciation, Baltha

[Tall_Allen]

Radiation of the metastases is different from radiation of the prostate. They would not use IMRT or brachytherapy. They would use one or two zaps of SBRT. They can also do ablation with cryotherapy. It is a good idea to have Provenge with it.

[cesces in reply to Tall_Allen]

Tall_Allen

I thought you were not a fan of local treatment of metastasized cancer unless there is some local physical threat to something?

Why do you in this case seem to support the use of sbrt radiation treatment?

[Tall_Allen in reply to cesces]

I never said that. I have always been in favor of zapping oligomets if it is safe to do so. I emphasize safety because there is no known benefit. But why not try it, if safe?

[immunity1]

EBRT is fairly standard for palliative treatment of metastases in pelvis and femur. I have had them both and had multiple radiation sessions. You may have SBRT or a more generalised approach; your RO can advise . Be aware depending on dose there may be side effects (GIT damage etc).