Infiltration of the rectum

[GP24]

I know a patient who had a PSA value of 40 ng/ml and was diagnosed with an intraductal Gleason 8. He got a PSMA PET/CT and they found an infiltration of his rectum by the prostate cancer. Is there any alternative therapy to ADT for him?

[Tall_Allen]

I had a good friend who had that after SpaceOAR was used for his RT. It caused him endless problems and pain until the day he died. Radiation, thermal ablation, and focal surgery carry a very high risk of fistula, which is even worse. He was offered a diverting colostomy, which he refused, but towards the end he regretted having refused it.

[Hidden in reply to Tall_Allen]

I thought SpaceOAR is advertised as protecting the rectum during radiation.

[Tall_Allen in reply to Hidden]

In my friend's case, SpaceOAR was inadvertently injected into an EPE, pressing the cancer against the rectal wall and protecting it from radiation.

[JimJimJimJim]

Hopefully a less drastic treatment may give resulte, but tell your friend not to be afraid of an ostomy if it comes to that. Awful to contemplate, but you soon adapt. And it gets rid of that particular risk to your life.Shhh! Don't tell anyone else, but I had one done 27 years ago.

[billy1950 in reply to JimJimJimJim]

Hi Jim,

Was the ostomy a result of a recurrence?

The plan for me is HD/brachytherapy

due to a recurrence inside prostate. The same as GP’s friend with intraductal carcinoma. Concern about SEs…

Thanks,

Bill

[GP24]

Allan, Nal, Jim thank you for your posts! The patient is just diagnosed, had a biopsy and a PSMA PET/CT. I think he will be reluctant now to get a chemo plus ostomy followed by surgery. Although this would probably be effective.

Jim, if the patient would also live in Australia, he could get into the #LuTectomy trial at PeterMac:

twitter.com/DrMHofman/statu...

This means a Lu177 therapy now followed by surgery.

[donits]

Hi, The patient can google the topic: "Therapeutic cancer vaccine shows promise against multiple tumor types". A new vaccine is being experimented on at the Tisch Cancer Institute at the Icahn School of Medicine at Mount Sinai in New York City. About fifteen people have received the vaccine so far, and the results are said to be very promising. The research is conducted by the lead researcher Dr. Thomas Marron assistant director for the early phase and immunotherapy trials.

[Currumpaw in reply to donits]

Hey donits!

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Currumpaw