PSMA scan results.

[Echotango51]

My MO and URO both called me about my results. I have 2 LN’s that were positive. One in the chest cavity and the other in the pelvic area. I asked both about radiating them an they both said no, the LN’s are very small. The xtandi will take care of them. I take my pills a night before I go to bed, I haven’t had any side effects and the pills help me fail a sleep.

[Tall_Allen]

I'm glad that you're tolerating Xtandi so well. It was a good call about no radiation in the chest cavity- that can be dangerous.

[Gabby643 in reply to Tall_Allen]

Thanks T A

[MateoBeach]

It is not true that Xtandi will “take care of” the metastatic lymph nodes. In the near term it will, but in the long term it will fail (cancer becomes resistant to it) as per all the hormonal treatments. Unfortunately for ALL of us.You are now oligometastatic to lymph nodes at this time. Perhaps radiation would also be ultimately futile as, even if the two nodes could be reasonably and successfully targeted with SBRT, there is a high likelihood that many other micromets already exist. So that is why they are recommending systemic hormonal therapy as the best choice now.

Well I am in the same situation, and elected to have radiation (SBRT) to two PSMA avid LNs. Then followed this with Lu-PSMA radioligand treatments (J591) in an attempt to target the unseen micromets that are probably there. SOC? No, completely experimental. And I am not recommending It for you.

However, metastasis directed therapy for LN oligometastatic sites has shown benefits in trials. So I would not take the word of the urologist nor even the MO with regards to the feasibility of targeting with SBRT. Have a good radiation oncologist review the scan and give an additional opinion before closing the book on it. Also ask about whether the ViewRay MRIdian system for precision targeting could reasonably be used in the chest?

Just hoping for the best for you, even if you get the same answer after review by an RO.

[Echotango51 in reply to MateoBeach]

Thanks, I known that xtandi will stop working a so point, but I hope I can get years out of it. You might have a point about RO, think I will have the report an disk sent to him, if he comes up with the same opinion I will live with that.I don’t know what ViewRay MRldian is. We have CyberKnift at his location .

[Hidden]

I'll bet there are oncologists who would favor targeting or removing those lymph nodes. Systemic treatment when you can see the hot spots? Maybe Kwan at Mayo?