Tall_Allen8 months ago

Where are you located? Maybe I can recommend someone. Pelvic lymph nodes is a wide area usually treated with X-rays.

Maybe try Orgovyx and see if it affects your liver.

icanwintwice in reply to Tall_Allen8 months ago

last time I went to MD Anderson .....Im in Colorado now

Reply (0)Report

Tall_Allen in reply to icanwintwice8 months ago

You have Brian Kavanagh at UC Denver - he's one of the best!

Reply (0)Report

icanwintwice in reply to Tall_Allen8 months ago

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

Reply (0)Report

Tall_Allen in reply to icanwintwice8 months ago

Brian Kavanagh has a great reputation.

Reply (0)Report

16S4 in reply to Tall_Allen8 months ago

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.

Reply (0)Report

Tall_Allen in reply to 16S48 months ago

The only RO I know in Colorado is Brian Kavanagh.

Reply (0)Report

16S4 in reply to Tall_Allen8 months ago

OK, thanks.

Reply (0)Report

Guber8 months ago

Why would you start Zytiga if the Lupron is working?

icanwintwice in reply to Guber8 months ago

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.

Reply (0)Report

Magnus19648 months ago

I am not sure I would add the Zytiga at this point since he is already on Lupron. Continue the Lupron after the surgery and see how the number go.

GP248 months ago

I would zap this lymph node with SBRT radiation. This affects this lymph node only and you are done with e.g. three sessions.

MateoBeach8 months ago

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. 👍

icanwintwice in reply to MateoBeach8 months ago

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

Reply (0)Report

MateoBeach8 months ago

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.

MateoBeach8 months ago

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. 🤔

mrssnappy8 months ago

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.