Treatment Decision

[dac500]

I have been treating my lymph node metastatic prostate cancer ( about 10 abdominal and pelvic nodes) with Lupron since November 2018. Previous imaging were performed with PSA around 0.1 and were clean. On June 1, I had Xray, CT scan, and bone scan one year into ADT break. CT scan found enlarged lymph nodes for previously diagnosed and a new enlarged lymph not detected earlier. This time my PSA was 1.1. I see my MO tomorrow. I would insist resumption of Lupron/Eligard shots at the minimum.

Would there be any benefit from aggressive treatment adding Zytiga/Apalutamide? I would appreciate any other suggestions. Radiation treatment for the newly found suspicious retrocaval node may not do much good. Because there could other smaller metastasis undetectable by CT scan.

[Tall_Allen]

This trial proved that there was an advantage to also adding...

Xtandi:

sciencedirect.com/science/a...

Erleada (Figure 1B - initially diagnosed as M0):

nejm.org/doi/full/10.1056/N...

[BruceSF in reply to Tall_Allen]

TA- the two URLs are the same, can you fix the Erleada one?

[Tall_Allen in reply to BruceSF]

Thanks - I put in the correct link now.