Primary SBRT / Stage 4

[reconjj]

So I understand once you have primary radiation to the prostate , SBRT , as I did , you cant radiate again ? Ok , so Im stage 4 with 1 hot lymph node in pelvic area . Starting tomorrow 3 days in a row 9 grays each day to the node . Then followed by 25 fractions of IMRT . So dont know yet if any radiation is going to be given to the prostate area . ? The question is if I still have a prostate giving off PSA could that prostate still be giving off micro-mets that dont show up on a Pylarify tracer ? And during the IMRT should the prostate area be radiated ?

[Tall_Allen]

No your prostate will NOT be radiated. Your prostate was already successfully eradicated of any cancer in it. There is NO evidence that there is any cancer in your prostate. The only cancer found is in your pelvic lymph nodes- THAT is what will be treated.

PSA is just a biomarker, not cancer. Your healthy prostate absolutely does put out PSA and always will. It has nothing to do with cancer, which now, is only in your pelvic LNs, as far as anyone can tell.

[ron_bucher]

I don't see your history, so I don't know how applicable my comments might be. I had local IMRT in 2007-2008 a year after prostatectomy, and then in 2017 I had (in addition to Taxotere) radiation of more lymph nodes outside (above) the local area (without any tumors detected by scans).

I've heard UCSF has radiated the same tissue in some guys as a follow up to poorly planned targeting by previous providers, but my radiation oncologist says he has never seen cancer reoccur in any tissue he has radiated.

[babaxiong]

I had 44 EBRT in 2018….my PSA was undetectable but rising slightly. I pushed for two years to get a PSMA PET SCAN, received it in April only to find a 3mm tumor in my sacral lymph node. Hit that with 5 IMRT sessions. Good luck.