Stage IV N1 , Radiation, Dr. Snuff Meyers

[reconjj]

Hello All , I have hot node in pelvic area picked up by pylarify scan at VA . . scheduled for 3 sessions of SBRT , then 25 sessions of IMRT at Illinois Cyberknife , Dr. Hirsch . . I go next week for planning where there are going to give me some Intravenious dyes , tests , to see the pelvic area of where all the organs assoicated with the complete pelvic area are . My question is I still have a prostate from primary SBRT 6 yrs ago . I read Dr. Snuffy Meyers , research done at MD Anderson said to radiate the prostate to prevent further mets from being generated by it . Snuffy referred to it as the " Mother Ship " . Did anyone here have this done ? And if so were side effects worse ? Thanks All , Merry Christmas .

[6357axbz]

Per my MDA docs I had RT to my prostate. 28 sessions, 5 days per week. No significant SE’s

[treedown]

I had whole pelvic area and retroperitoneal lymph nodes up to aortic bifurcation radiated with no side effects other than minor anal bleeding for 2 days at the end. I am almost 2 years to the start of 44 treatments. That said we are all different.

[Tall_Allen]

You already had your prostate irradiatedd. That's what SBRT is.

[reconjj in reply to Tall_Allen]

Hello TA , I dont understand . I had SBRT , primary treatment , but I still have a prostate . So I cant have the prostate radiated again ? Maybe I dont understand Dr. Meyers thought .

[Tall_Allen in reply to reconjj]

Snuffy Myers has nothing to do with your case- he is talking about men who have not yet had their prostates treated. There is no cancer in your prostate, so there is no point in having retreatment of it.

[reconjj in reply to Tall_Allen]

Thank You for clearing that up for me . Merry Christmas Allen .

[EdBar]

Yep, had it done during my first year after dx of stage 4 PCa. I went on to have about 6 years of undetectable PSA - was on triple ADT and had chemo per CHAARTED too which I’m sure contributed. I was a patient of Snuffy and he made the mothership reference to me during one of my visits, said radiating the prostate and affected nodes was one of the best things I could have done.

But if you already had your prostate radiated you can’t have it radiated again.

Ed

[Scout4answers]

My question is over side effects of radiation :is longer (44 sessions) at low dose more effective at lowering side effect vs higher dose in 25 sessions . Not asking about survival or time to recurring only quality of life side effects.

[cesces]

1. There seems to be a a lot of research that says once you go metastatic, unless you have a tumor impinging on something, you shouldn't use localized treatment. 2. I am an old Snuffy Myers patient. As the data changed his treatment protocols changed, sometimes substantially. I don't think you can blindly rely on anything he was saying without paying attention to how old it is

3. Dr. Kwon's team at Mayo does a lot of very nuanced local treatment of metastatic cancer based upon their data and experience with 4,000 patients per year. Check out his 3 part 2021 YouTube on the subject. And see if you can get a second opinion from them.

4. Myers had about 2,000 long term patients, a large number of whom had lymph nodes treated with heavy radiation. He discovered that most of them were getting their Cd4 T-cells killed off as they circulated through the lymph nodes during treatment. All the other T-cells grow back. Cd4s do not. So me and a whole lot of his other patients were left permanently immunocompromised. My other Doc was impressed that he even noticed this and tested for it to figure it out.

I would explore non-radiation treatments for metastasis in the lymph nodes. And at a minimum track your Cd4 T-cell levels before and after each individual radiation treatment of your lymph nodes.

It's a cheap blood test. If you find it headed out of range, insist on stopping the treatment of your lymph nodes with radiation.

[Spyder54]

After 13 months of Triple ADT, and my PSA finally down to .56. I am scheduled for 5 Radiation treatments of Prostate only. Memorial Sloan Kettering believes there is no known Survival benefit in radiating the lymph nodes also.Dr McBride said my enlarged lymph nodes have shrunk considerably on latest scans so our focus is on Prostate only. MSK Precise using MRI w CT at 90 degrees and ultrasound all combined on one image. I have 3 gold seeds implanted and 10 tatoo’s (dots) that align with lasers and a body cast to hold me in place for zero movement. Gas X tabs and daily Fleet enemas to avoid gas in the rectum which can move the prostate if not minimized. They are discussing up to 70 Gy’s in 5 sessions only (just as effective as 30 sessions according to several studies). This is Image Guided Stereotactic Ablative Radiation (IG/SBRT) that has been successful at killing the prostate with low risk (1-3%) of bladder, urethra, or rectal damage.

So I’m taking a shot. Still not clear if it will be 5 consecutive days or space in between. Heavy Duty…yes. But from what I have read, the Prostate doesn’t die easily, it needs a good solid hit to be effective.

Best,

Mike