After prostate surgery 2007, radiation 2009 general area, PSA went up 4.6.
Started on Lupron, hot flashes, very very tiredness, switched to Casodex. PSA went down back up and dow again, from .23 to .83 recently. Went in for nuclear scan, showed lymph nodes only area positive. What is the treatment now, Radiation, Chemotherapy, different drug. ?
Have pelvic lymph nodes been irradiated?
not yet, meeting next week on options
It is a last chance at a cure. It has to be given along with 2-3 years of ADT.
You can try radiation. And add Lupron with estrogen patches for the side effects.
There is some controversy thst bathing the lymph nodes with radiation can kill non-replaceable cd4 T-Cells. They are sort of important.
Ask them if they can poke a hole and remove affected lymph nodes endoscopically..
What does radiation of the ‘general area’ mean? You either had it to the prostate bed only or a larger area which included the pelvic nodes.
Important to know. Since it was 13 years ago it was probably only the prostate bed, and radiation of that larger area is a good option.
During "prostate surgery" was prostate removed totally or partially? How long was Lupron used? Any pain in lymph nodes? Lymph nodes in pelvic area only? "Nuclear scans" whole body or just pelvic area? CT scans?
I have to guess a lot but I assume you have pelvic lymph nodes that trapped PC mets years after surgery. Seems so long after surgery that it could be from portions of prostate not removed and recently started new cancer cells.
PSA in low levels (like you say) can mean either a portion of prostate was not removed, or PC metastasis has occurred. Casodex I was told lowers testosterone from adrenals, not from testes. So testosterone is a bit lower but not low enough to make much difference. Have you tested serum testosterone?
Lymph nodes act like filters that can trap larger cells like metastasis. I have had many lymph nodes, mostly on back, that have been swollen from PC but they have gone away after Lupron/heat/lycopenes.
What date or year did your scans show lymph nodes involved ?
Scans do not see anything smaller than 3/8". I felt pain from them on my back as early as 2013 and treated them with Lupron, and lycopenes and heat. They always went away or were too small to be detected by scans, until 2020, when similar sore spots occurred on my neck. Those also are no longer causing noticeable pain.
So if I were in your shoes and had <.1 PSA and no mets on CT, then any pain, discomfort, ailment I should assume is a lymph node met?
Not necessarily so. A pain can be from a pulled or strained muscle or a bruise. The way to tell the difference is that a metastasis will not heal, whereas a bruise or muscle strain will usually go away in weeks. Also a met can swell over months as it grows and your immune system tries to heal it with lymphocytes. Lupron stops the growth by starving them of testosterone, and lycopenes increase numbers of killer cells in your blood, that devour the cancer cells, and heat above 106 degrees F kills the cancer cells
Really? It's all figured out? Are you a Dr. or medical scientist?
I have bonafide metastases' on CT's, and scans and have experienced their effects. I disagree with what you say.
As I have noted previously I cannot tolerate ADT so that is not an option. My PSA this year went from 8+ to 12.5 three months ago and is not 13.3. This is exponentially higher than a long of people on here are concerned about.
A summer PSMA PET/CS scan showed multiple lymph nodes in multiple areas have cancer activity. The issue of radiation for these lymph nodes was discussed with my oncologist since he and I know that this is sometimes done for specific identified and located lymph nodes with PC. My MO said that radiation is not recommended because the lymph nodes with PC are wide spread with several positive in each area (from my shoulder to my pelvis).
He said that radiation in this case would not be able to get all the PC out of my lymph system and it is still as likely to spread further even if the nodes were zapped. And that the amount of radiation to a multiple areas to multiple nodes in each area would cause more harm (i.e. very dangerous in and of itself) than good. I understand and agreed to not getting radiation to these identified lymph nodes.
Interestingly, he also said that recent research has found that having PC in the lymph system may have been there at some or all of these areas before I was officially diagnosed with PC and had my radical prostatectomy. The PC was in all. related organs except the bladder and bladder sphincter. And my entire prostate was riddled with PC and the margins were positive after surgery. So I definitely had a serious PC problem. On one side all the lymph nodes were surgically removed as a preventative procedure but the other side was not because scar tissue from a previous surgery to repair a hernia in the same area. The lymph nodes that were PC positive from the PSMA scan were on that side but not the other.
I suspect that might indicate that the spread of the PC to upper and lower lymph nodes on that side were due to spread from the my prostate after surgery.
So the SOC for radiation to lymph nodes is that it is only done if the number of positive lymph nodes is small and localized. The PC will not only be in the lymph nodes but also in the lymph system vascular system meaning it would still be able to spread after radiation.
Just FYI from what I found out in my case. Radiation will not be recommended in every case. My PSA will continue to rise in my case from an already high level, and the rise will be in increments that are multiple amounts compared to others. This is serious but even still radiation will not likely work, will be very dangerous, and will not likely halt the spread of the PC.
If your lymph nodes are restricted to a single area then radiation therapy would be a better option.
I have applied heat locally with various sources at the metastases, in my case lymph nodes in my back, neck, and skull. It does not cause problems. I have used a thermometer and it seems 110 F is quite harmless although a bit painful, momentarily, with a shower. I have used up to 120F for under a minute which worked for my skull mets. I have used heating pads with cloth buffers and even fallen asleep with no problems. I have used heated 2.5 lb weights up to 140 degrees with cloth buffers for short periods, minutes, without problems. Hot showers cause reddening of the skin but that goes away. There are hospitals that use heat with chemo but they usually keep temperatures under 110F. I don't know about clinical trials but it was discovered in the 1920's that heat kills cancer cells. I just experiment with all sorts of cancer killing methods and foods and spices and I have been successful. I have yet to have any physical after-effects. One should be careful, though, I agree. Dont stick your ass in boiling water!
I'm sorry but again what metastases'? Your PSA has been <.1 for years and you have no metastases' on CT or bone scans.
My mets were too small to see on scans and I eliminated them before they were big. Latest scan two years ago showed mets on lymph nodes on neck, but they are gone now. Also skull mets showed on a scan but they are gone now. I still have a sore rib but it couldn't be seen on scan and has improved since. I have eliminated over a dozen back pain spots, a tailbone spot, and several skull pains, which I believe were lymph node tumors. Also One tumor got into my spine between shoulder blades, but it is now no longer painful, I think it may be gone.
My PSA dropped from 35 to <0.1 when I resumed Lupron after a four year vacation.
I'm on Lupron continuously now, every 3 months.
Success with SOC treatment, lucky, and naive all in one.
Lymph node treatment 
Update, tumor in lymph node
Lymph Node Methasizes
Focused radiation on the met lymph node
