SBRT Failure , offically

[reconjj]

Hello All , I had my PSMA -PET , Pylarify today at VA . They the VA Onc called me a few hours ago and the cancer is outside the prostate and in 1 node . i dont have the specs yet of size or area . But he said Hormone therapy to start , that I knew . So what are my options so far ? So if its in 1 node can SBRT be used ? or should the whole pelvic area be radiated ? Would I be a candidate for Dr. Datolli for the ( USPIO Ferahemi , Mri ) at Sand lake imaging center and the off to Dr. datolli for treatment ? The VA gave me a DVD of the scan , but yet to read the final impression . Thanks , SemperFi , JJ .

[Tall_Allen]

You may still be curable. Go back to your RO and ask for radiation of the pelvic lymph nodes. You will have to have ALL the pelvic LNs irradiated (lymph is a fluid and it carries the cancer slowly to all the nodes in the drainage area). She can give a little extra radiation to the detected lymph node (called a "simultaneous integrated boost").

They stopped giving Fereheme years ago - it didn't work. At any rate, there is no point in detecting more since you will have radiation to the entire area anyway. In LA, they do 25 Gy in 5 treatments. Dr. Hirsch may do that or she may use more treatments. Datolli drags it out because he bills per treatment ( I can't imagine why you'd use him).

[reconjj in reply to Tall_Allen]

Thanks Tall Allen , I will talk to Dr. Hirsch soon . Would I be needing ADT before and after radiation and would that be lupron or another ?

[Tall_Allen in reply to reconjj]

I'd discuss starting 2 months before, and at least a year after RT. Also discuss adding abiraterone (maybe with a Decipher test if the VA will cover it.). It can kill off any stray micrometastases floating around.

[Lieto55 in reply to Tall_Allen]

Thanks for this input. I'm starting Zytiga next week augmenting Eligard + IMRT/SIB + SBRT. IMRT to PLN was 25 fractions at 2.25Gy. (We declared BCR at PSA .22ng/ml.) I'd been nervous about Zytiga but I suspect/hope it will be like the Bicalutimide and Lupron, something I can adjust to. As the rascal got up to the T10 vertebrate and a cluster near the sacrum, knocking out the micromets while the PSA had been low gives me the drive to adapt to 2 years on Eligard/Zytiga. Great input.

[Tall_Allen in reply to Lieto55]

Usually, most of the side effects are from the ADT.

[Tommyemily in reply to Tall_Allen]

Please take care, statements like your last statement would be considered defamatory in most jurisdictions.

[Tall_Allen in reply to Tommyemily]

LOL- Please sue me.

[Tommyemily in reply to Tall_Allen]

Just friendly advice - Seasons Greetings to all

[Tall_Allen in reply to Tommyemily]

Not very friendly and not interested.

[j-o-h-n in reply to Tommyemily]

I know you meant well - but nothing wrong with telling the truth..........

We have a joke in NYC about a Korean/Jewish law firm named "Sosueme".....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 12/09/2021 7:57 PM EST

[SPEEDYX in reply to j-o-h-n]

DIdn't he once belong to the firm...Hungadunga Hungdunga and McCormick!!!

[j-o-h-n in reply to SPEEDYX]

I think you mean the 1939 B&W Movie, Gunga Din starring Cary Grant, Victor McLaglen, Douglas Fairbanks Jr. and Sam Jaffe.

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 12/09/2021 9:24 PM EST

[SPEEDYX in reply to j-o-h-n]

My fathers favorite movie of all time

[j-o-h-n in reply to SPEEDYX]

I enjoyed it too......... watched it many times.......

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 12/09/2021 7:57 PM EST

[Hidden in reply to j-o-h-n]

Victor McLaglen, Sargent major in the John Ford, John Wayne cavalry trilogy.

[j-o-h-n in reply to Hidden]

He used to be a boxer..... fought towns people with circus.....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 12/09/2021 10:35 PM EST

[j-o-h-n in reply to Hidden]

My Ellis Island research (hobby) regarding famous people (Victor McLaglen):

Victor Andrew de Bier Everleigh McLaglen (10 December 1886 – 7 November 1959) was an English boxer and World War I veteran who became a successful film actor.[1] Towards the end of his life he was naturalized as a U.S. citizen.

See Ellis Island records:

Name Ronald Victor Andrew de Bier Everleigh McLaglen

ship's Name Republic

Date of Arrival July 29, 1924

Passenger number 600678050110, Frames 781 and 782 line number 4

Mr. Mclaglen became a naturalized U.S. citizen.

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 12/09/2021 10:44 PM EST

[Hidden in reply to j-o-h-n]

He played a great drunk. All 3 movies.

[j-o-h-n in reply to Hidden]

I think cause he was............

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 12/09/2021 10:49 PM EST

[j-o-h-n in reply to Hidden]

BTW if you have any relatives that immigrated here via Ellis Island during the very late 1800's and up until the mid 1950's I can research them for you. It's a hobby and I do it for the fun of it (no fee). One of the few criteria I have is that their names are not common names such as "John Smith", "Edward Jones" and etc. Too many to search through and able to get a hit. The more the name is unusual the better. The offer is there if you want....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 12/09/2021 11:16 PM EST

[bean1008]

Hey recon…my G68 scan 14 months ago showed tiny mets in two lymph nodes and a spot on my pelvis. I went straight onto Lupron and Zytiga and my PSA has been undetectable since last February. We talked about radiation but are keeping that on the back burner for now. Treatment plans can be a tough call and you should discuss with both an MO and RO. I was in a recent clinical trial for ‘neutron radiation’…the lead physician believes it will surpass the efficiency of the current options for radiation. Tighter beam focus than proton and fewer sessions is their hope. Best wishes!

[reconjj in reply to bean1008]

Thanks for the reply , how have the side effects been for you on lupron and Zytiga ?

[Scout4answers in reply to bean1008]

Where was the neutron rad trial?

[bean1008]

Recon, my biggest complaint is fatigue. If I gave an extra busy day I’ll be wiped out the following day. I’ve learned to pace myself and not plan two busy dates in a row if possible. Hot flashes are sporadic but annoying. Bought a neck fan on Amazon that is my new best friend!

[bean1008]

Hey Scout…it was at the University of Washington Eadiation Oncology department. I believe it is still ongoing. I got the ‘control group’ so I’m still under SOC of Lupron and Zytiga. They told me that could be an option for me in the future though if it comes to be that I need radiation.

[Exrunner]

You stated you received the PSMA -PET , Pylarify today at VA. Would you mind telling me the location where you received the service. I have requested my PCP at the VA get info on the PSMA -PET , Pylarify as I am at the point I would like to get the scan.You refenced Dr. Datolli...did you use the VA in Tampa?

Thanks

[reconjj in reply to Exrunner]

Hello xrunr , my PSMA-PET , pylarify was done Dec.7 at Hines , VA Maywood IL.. Got the results same evening , not good dx , stage 4a -m1 , in 1 tumor in the pelvic lymph node . Received 1 jab of Eligard today . It was great service at the VA .

[Exrunner in reply to reconjj]

Thanks for your quick reply. Sorry to learn of your DX. Hopefully since you know where the tumor is you will be able to use SRBT to get the main source of your PCa.Wishing you the best.