CT Scan Report

[dac500]

I had CT scan today showing :

LYMPH NODES: Interval enlargement of a few retroperitoneal lymph nodes:

* Right external iliac lymph node measures 0.8 x 0.7 cm (series 4, image 251), previously 0.3 cm on 6/2/2021.

* Right common iliac lymph node measures 0.9 x 0.8 cm (series 4, image 232), previously 0.5 cm on 6/20/2021.

* Retrocaval lymph node measures 0.5 x 1.1 cm (series 4, image 175), new.

Remaining previously described FDG avid retroperitoneal and right iliac chain lymph nodes are unchanged (series 4, image 230, 233, and 294).

[Nusch]

Are you under any treatment regime? Which one? Did you also do a PSMA PET? I would highly recommend.

[dhccpa in reply to Nusch]

Apparently, the thinking is not to use the PSMA unless there is a possibility treatment will change. Not sure if that is the case here.

[j-o-h-n]

Sorry. And your question is???

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 06/02/2022 6:38 PM DST

[MateoBeach]

Would promptly consult a radiation oncologist to consider salvage radiation to all the sites (lymph node fields in the pelvis as well as prostate /extracapsular sites. And see if it is reasonable to use targeted SBRT to the one retro-caval node. Some would say this is likely futile. But it might be your last best chance. And then follow it with a systemic treatment such as docetaxel chemotherapy or, what I am using, Lutetium J591 treatments available through GenesisCare in Perth (Dr Nat Lenzo, Theranostics AU). You may fit their clinical trial criteria for this.However, the RT would have to be found feasible and done first. Paul

[dac500 in reply to MateoBeach]

I had brachytherapy in 2011 and cyberknife for extra-capsular recurrence. More over the metastases were discovered by PET/CT scan and lymph node biopsy in multiple pelvic and abdominal lymph nodes in 2018. Another radiation treatment was not advised. The recent CT scan found a new metastasis in retrocaval lymph node. It is possible there are multiple new metastases too small to appear on CT scan. I would mention radiation to my oncologist during Monday's appointment.

[MateoBeach in reply to dac500]

I didn’t catch the part about multiple abdominal nodes as well. The RO May find that futile then. Unfortunate. Did they get tumor genetics when the lymph node was biopsied?