2nd radiation potential

[Fightinghard]

Wondering if you can take another round of radiation?

Had 80gy of pelvic and prostate bed rad 4 yrs ago. Latest PSMA scan shows several significant lymph nodes along each sidewall of pelvis.

Been on systematic treatment Lupron for 2+ years.

Could IMRT or Proton target just the large lymph nodes and slow down the spread? Realize it is systemic spread but thinking it might help to hit the hot spots with another dose of radiation.

Or would risk to organs be too high?

Any thoughts?

[Tall_Allen]

You should talk to a good RO. They delivered 70Gy to the prostate bed (not the pelvic area), but how much to the pelvic LN area - and did it include where these new spots are?

[Fightinghard in reply to Tall_Allen]

TA. I do not know. I will talk to a good RO and ask to have my old treatment records sent to him/her to review.

Assuming it is ok, do you think blasting the larger LNs will provide any benifit or slow progression? (I was thinking that it might be similar to debulking the primary tumor)

Thanks for the response.

[Tall_Allen in reply to Fightinghard]

Maybe. So far, there's no good studies showing a benefit, although it will certainly reduce PSA (for whatever that's worth). Given the lack of good data, safety should be your #1 concern. It's not worth a fistula.