Ive been diagnosed recurring prostate cancer in my lymph node only. Ive taken a 6 month Lupron injection (PSA down from 2.0 to .11) , recommended for Zytiga, then radiation as soon as possible. My liver numbers are up due to the Lupron injection and not sure I can make it through the Zytiga. Might end up on something else. I am really worried about where to go for my radiation. and what kind. Proton or Xray(photon). I did Proton last time and it worked on my prostate and seminal vesicles. No cancer there. Just a 3m by 3m tumor in my lower pelvic lymph node 6 years later......
How do you tell who is good at radiation and who isn't? and what kind?
What is my best fallback if the Zytiga doesn't work?
After the Lupron, Zytiga, and the radiation, should I do Taxotere (chemo)?
All input appreciated.......
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icanwintwice
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Ive picked out a couple but how can you tell who is good and who isn't . I have some local smaller hospitals that do radiation and the doctor seems competent but not sure how to know for sure
TA, I’m wondering if you have any knowledge of an RO Thomas Pugh with The Urology Center of Colorado(TUCC). I am scheduled for him to do my whole pelvic RT in August. He has an impressive CV and presents well in the face to face meetings we’ve had. I have not been able to find many patient outcome reviews or testimonials on him. Thanks.
Im not looking for palliative outcomes. Hoping for a curative outcome. There is a study that shows Zytiga in combination with Lupron for 18 to 24 months and radiation, can result in a better than 50% outcome for non recurrence up to 6 years. So far that is all the data they have as I understand it. After the 18 months some are recommending 6 rounds of Taxotere to complete the treatment.
My son age 50 had tertiary 5 spread to pelvic lymph nodes after robotic surgery October 24th. He was put on Lupron and generic Zytiga/prednisone plus given 6 weeks of IMRT. His PSA dropped from 20 to .07 in 3 months. This coming week will be his 6 mo check up at UCSD. I asked the same question about Taxotere and his specialist will not do it unless there’s evidence of spread…. Hopefully 🤞 there won’t be. Good luck to you too.
Where there is one positive pelvic LN seen, there are certainly others unseen. SBRT is not sufficient. Full pelvic LN fields need to be treated with IMRT (X rays), both sides, up to aortic bifurcation, with a boosted dose to the identified node and short term adjuvant ADT. Not sure how much adding abiraterone to that actually adds. Go for the win. 👍
Thank you for your input. The radiologist is saying what you wrote. Both lymph nodes with IMRT. I agree with you on the potential for microscopic cancer in my lymph node. Even though I did a PSmA scan that only detected the one tumor. The people Ive spoken to are saying 24 months on Lupron and Zytiga combined with the radiation, or 18 months on those two, radiation, then Taxotere for chemo? seems like a lot for a 3mm by 3mm lymph node that took six years to grow after my last radiation treatment?.....also the Lupron shot made my liver numbers go through the roof. they're not sure I can make it through the Zytiga Lupron combination for such a long period
It does seem like a whole lot! Especially if your body does not tolerate ADT well. As is case with me. I recall the study showing improved results from 18-24 months adjuvant ADT vs 6 months was better. But in sub groups those with low PSA at the start did just as well with 6 months. I’ll see if I can find that study.
Cannot find the study breaking out the very low PSA group. So it seems the 18 month ADT is well supported in meta analysis vs 24-36 month. But 4-6 month not sufficient it appears. Ah well. 🤔
We are in Colorado and my husband receives treatment at UC Health in Aurora, not only for prostate cancer but for Parkinson's diagnosed in Feb., so he sees oncologist, radiologist, neurologist and physical therapist there. I think having your medical oncologist and radiation oncologist in the same place is an advantage. When we needed an opinion on PMSA Scan done in Los Angeles here before starting ADT, our MO had us see Dr. Tyler Robin, MD, PhD so you might also check him out along with TA's suggestion. uchealth.org/provider/ We have had nothing but positive experiences with all the staff at UC Health.
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Radiate just the prostate when there is extensive lymph node involvement?
Update on My Lymph Node Metastatic Prostate Cancer
Cancer spread to lungs and lymph nodes 
