Failing nubequa mono therapy follow up and salvage focal therapy options

[rococo]

Failing nubequa mono therapy with a doubling time of 8 months, Deciding what to do next with a Psa of 3,5. If adding lupron fails try orgovyx. Than what!, Recent f18 psma pet\ct scan showed local prostate reccurrence of 2cm tumor on left side of prostate non metastatic. R O said no salvage therapy on previously radiated prostate. Will visit cryologist for focal therapy and mri guided biopsy while on H T now or when med options become desperate. After all medically controlled 20 yrs from initial Psa reccurrence. Any comment on this complicated situation appreciated

[tango65]

Consider getting a second opinion since re irradiation could be done with SBRT or high dose brachytherapy.

frontiersin.org/articles/10...

[rococo in reply to tango65]

Where I can get it around Buffalo ny is my problem. Roswell comprehensive cancer MO turned me down. . I am 83 years old and in good shape

[tango65 in reply to rococo]

Consider getting a video consultation with a RO at the Memorial Sloan Kettering Cancer Center in NY. Medicare is accepted by MSKCC.

mskcc.org/departments/radia...

They could advice you about brachy and they may know somebody in Buffalo.

[rococo in reply to tango65]

Video consultation. Thanks tango65. Never thought of that. Will give it a try

[Teacherdude72 in reply to tango65]

Rochester has all treatments at the Wilmot Cancer Center.

[rococo in reply to Teacherdude72]

Just what I’ve lookin for. Thanks teacherdude 72. Will check this out. May also be helpful to my us too group

[Teacherdude72 in reply to Teacherdude72]

The Wilmot Cancer Center at Highland has the High Dose Brachy and the regions leading expert on it. Low dose also.

[rococo in reply to rococo]

Need someone good on doing a search for me of MO who will treat me preferably near Buffalo ny

[Teacherdude72 in reply to rococo]

Short travel to Rochester and the Wilmot Cancer Center. Part of Strong Hospital. Also at Highland Hospital where the Chief of Radiology is. Wilmot has all the up to date treatments. They have many great Oncologists. Please PM me for details and my experience with Nubeqa. I am 7 years in with G9 PCA.

[rococo in reply to Teacherdude72]

Was on lupron before. Nubequa mono and will add relugolix which is more effective in pill form that you can start and stop any time

[Tall_Allen]

You can have salvage focal brachytherapy, but you have to talk to a radiation oncologist who specializes in brachytherapy.

prostatecancer.news/2017/09...

[rococo in reply to Tall_Allen]

Thanks TAll Allen. Very helpful info

[Teacherdude72 in reply to Tall_Allen]

Rochester NY has the regions expert on Brachy at the Wilmot Cancer Center in Highland Hospital. The Chief of RO does the radiation planning. Short drive from Buffalo.

[Currumpaw]

There are other types of ablation treatments available as well. HIFU has been in use longer than FLA, focused laser ablation. Your RO knows how much radiation you have been exposed to.

Choosing someone experienced in whatever type of ablation you decide on is very important just as choosing an experienced surgeon is.

It might be best to have the ablation sooner than later. That decision will be your decision after your MRI and biopsy.

The FDA has announced its conditional approval, pending minor changes to the protocol, for a clinical trial for the treatment of recurrent prostate cancer with the Sonablate (R) 500 (HIFU) in men who have failed external beam radiation therapy.

FDA Approves HIFU Clinical Trial For Recurrent Prostate Cancer - …

malecare.org/fda-approves-hifu-clinical-trial-for-recurrent-prostate-cancer/

malecare.org/fda-approves-hifu-clinical-trial-for-recurrent-prostate-cancer/

My best to you,

Currumpaw

[rococo in reply to Currumpaw]

Thanks curumpaw, Going on adt hopefully to supress the the tumor before mri, biopsy and treatment, Checking with cryosurgen first, Would really want to have sort if I only had the resources to find an MO near or far if necessary from Buffalo ny

[rococo in reply to rococo]

Sorry that’s cyberknife stereotactic sbrt, mispelled

[Teacherdude72 in reply to rococo]

PM me for more insight on Wilmot Cancer Center in Rochester NY.

[MateoBeach]

Go consult with a different RO at a major center. Re-irradiation for salvage (SRT) in prostate confined disease is being done. I would favor it over cryo, personally. Don't let the opportunity for cure pass you by.

[MateoBeach in reply to MateoBeach]

And yes, HDR brachytherapy may well be the best of all. If you need to travel to get it from an expert, then go! Your life is on the line, and we all want to see how it turns out in the long run! Be cautious of those over-selling Cyberknife and HIFU, Protons and Cryo. If you have a hammer . . .

[rococo in reply to MateoBeach]

But I probably been keeping this cancer confine to the prostate since Psa reccurrence 20 yrs ago with HT manipulations as better treatment evolves. My theory is suppress till crpc than.treatment

[rococo]

And I miight be getting close to castrate resistance which is why Iam researching both HT meds and salvage focal therapy before I travel alone to make the plunge, So far as I can see Buffalo is a barren land advanced pc

[WillowHawk]

Not sure if you might need help getting a ride to Rochester. You could check with Amer Cancer Society. 1-800-227-2345. Or get some audio books from the library, if you still drive, to make it less annoying. I think you should rethink trying to stay local at this point. Once you got to Wilmot Cancer Center, you could ask them about doctors near your home.

[rococo in reply to WillowHawk]

Their web site gives no info treating adv pc. Found fox hosp in Philadelphia penn. with excellent adv pc treatment record. Their search appt. is great

[billy1950]

In 2021 i had a recurrence after 17 years. I was treated with EBRT in 2004-5…Confined to prostate. Looking at salvage SBRT…Did you have salvage treatment ?