first PSMA

[runtrails]

What was your timeline? I know my RO said in our last meeting, assuming PSMA is node neg and distant met neg), that I would start Casodex (I already have the pills) day after the scan, a couple weeks later, Lupron, and the a couple weeks later the first full pelvic radiation (35 at 70 grey) Is that SOC? Antiandrogen a little before LHRH, which is a little before salvage Rad? I am hoping I posted it accurately from memory. Have some notes but am not at home.

[Justfor_]

Probably not SoC at this point in time, rather next SoC or SoC+ if you please. Currently, many ROs still irradiate blindly in a try and fail fashion. With your persistent PSA profile the existence of distant metastases can't be overlooked, as in such a case sRT will only bring you long term toxicities. More here: healthunlocked.com/prostate...

It is a very good and up to day plan, only thing that I would change is to start taking Casodex 2-3 weeks before PSMA scanning, as it is believed to stimulate PSMA expression, thus rendering the imaging more sensitive.

[Tall_Allen]

Yes, that's SOC. The full pelvic is at a lower dose (usually 45 Gy in about 25 treatments) and they are probably adding 10 treatments to the prostate bed so it gets 70Gy. The Casodex prevents a painful flare of symptoms that can occur when Lupron is started. They often wait 2 months before beginning radiation, but if your PSA becomes undetectable sooner, they can start sooner.