Thoughts on upcoming treatment of recurrence?

[Wynnsts]

Prostate cancer recurrence in 2 lymph nodes and very small spot on iliac bone. PSA rose from 1.7 to 5.1 in six months. Dr Torresrocca at Moffit in Tampa proposes 5 high dose radiation treatments along with Eligard and Bicalutamide. Prostatectomy 08/2016, SRT 07/2019. Thoughts and side effects to expect? Thanks in advance!

[GP24]

I would get this treatment done and take Eligard for six months after the radiation. This radiation usually has no side effects and the side effects of Eligard are limited to about six months.

They did this therapy in this trial. jamanetwork.com/journals/ja... They did not use Eligard but that will improve the effect of the radiation.

[Wynnsts in reply to GP24]

Thank you GP 24

[Hidden in reply to GP24]

I was reading the study you linked....I could not easily tell if the mets were identified by psma imaging or older technology. Do you know?

[Wynnsts in reply to Hidden]

Mine were by Axium PSMA but I think you’re referring to the study noted by GP 24

[GP24 in reply to Hidden]

The study protocol stated the mets should be detected by standard imaging (CT/bone scan). However, more than half of the patients got an additional PSMA PET/CT with the results blinded to patients and their doctors. At the end of the study it was checked if the standard imaging provided the same results as the PSMA PET/CT. The patients who had no additional mets on the PSMA PET/CT versus standard imaging had better results.

This means the patients who got all mets treated which showed up on the PSMA PET/CT had the best results. The patients who had untreated mets because they did not show up on standard imaging had not so good results.

[Tall_Allen]

What are your expectations?

[Wynnsts in reply to Tall_Allen]

At this point I have none, but I would like to outlive my prostate cancer. Currently I’m following the advice of my Radiologist and I would like to hear from others with more experience in treatments than myself, as in almost 6 years I’ve only had two. I’m 74 and would like to hang out a bit longer. Thanks for asking TA, as I know you are very knowledgeable.

[Tall_Allen]

Good. Because no one knows if the metastasis-directed radiation adds to survival, but the Eligard certainly will.

[Wynnsts in reply to Tall_Allen]

Thanks TA

[Howard53545]

I had two lymph nodes discovered via scan. We nuked the entire pelvic area followed by 2 years of lupron, on second year now. Currently undetectable.

[Wynnsts in reply to Howard53545]

Thanks Howard, that’s fantastic

[E2-Guy]

12 years post RP my PSA rose to slightly over 1 at which time I opted for the Ga-68 PSMA scan which identified metastases in 5 sacral LN's. I chose surgery to remove those plus 3 additional ones deemed malignant during the procedure. This surgery reduced my PSA by about 50%; however, within six months my PSA began rising again. Reluctant to subject myself to traditional ADT, I started applying tE2 gel (38 months ago) and today my PSA is at 0.003 with ONLY small boobs as a SE.

Tall_Allen questioned the validity of the surgery since he assumed that the scan was unable to identify the smaller metastases...obviously he was right as usual! I will always consult with 'Dr. Allen' prior to doing anything in the future.

[Wynnsts in reply to E2-Guy]

Thank you for this info and great to see such fantastic results!