Anyone with knowledge, personal experience, studies, trials with Radical Prostatectomy after bone, lymph node and/or soft tissue metastases?

[Shorehousejam]

Found this:

Treatment with radical prostatectomy (RP) plus adjuvant external beam radiotherapy (EBRT), androgen deprivation therapy (ADT), or both (MaxRP) provides equivalent survival outcomes as EBRT, brachytherapy, and ADT (MaxRT) in men with Gleason score 9–10 prostate cancer, according to a new study published in JAMA Oncology ..

[Seasid]

that is exactly what I want to know myself.

[cesces]

"Radical Prostatectomy after bone, lymph node and/or soft tissue metastases?"

That doesn't make a lot of logical sense to me.

[Shorehousejam in reply to cesces]

Point of the question, is to get out of the box thinking and experiences, about radical prostatectomy, to many it will make sense….does it apply to you?

Prostate Cancer that has escaped the capsule?

Any lymph, bone, or soft tissue involvement?

[Hidden]

There is a member here, HopingForTheBest1, that was part of a clinical trial where they removed a stricken prostate even with evidence of mets.

[Shorehousejam in reply to Hidden]

Thank you, we will hope that Tall_Allen will have information on this topic.

[Concerned-wife in reply to Shorehousejam]

My recollection was MSK was doing a trial on this. At least they were two years ago.

[Tall_Allen]

Here's my analysis from 4 years ago:

prostatecancer.news/2018/11...

[cesces in reply to Tall_Allen]

TA

I think the issue is: If you have metastatic cancer does it make sense, as part of your treatment for metastatic cancer, does a prostatectomy make sense as part of your treatment.

If I am right, and I properly read your article, it would seem to be the wrong article. The most relevant article would be the one showing that localized treatment doesn't help once you have gone metastatic.

It seems logical that a prostatectomy will not help unless there was some kind of stem cell mechanism going on.

[tango65]

Why is one going to have a radical prostatectomy and then radiation when it has been shown that if one has less than 5 metastases radiation to the primary tumor plus systemic therapy prolongs life.

ncbi.nlm.nih.gov/pmc/articl...

ascopost.com/news/august-20...

Unrelated to the overall survival advantage, I have the belief that treatment of the primary tumor is important for better control of of the cancer in the pelvis. Tumors in the prostate may stop responding to systemic treatment and progress locally affecting the bladder , urethers, kidneys, rectum etc.

[Seasid in reply to tango65]

that is true and that is my concern now.

[Seasid in reply to Seasid]

After sbrt of my prostate full of crpc m PSA dropped from 1.4 to 0.23 six months after the radiation (now 22/05/2023.)

[NecessarilySo]

Close the barn door after the horses got out?

[Seasid in reply to NecessarilySo]

I don't like that saying.

We are dealing with cancer. Tango65 is right. I know a member who ended up with radiation to his prostate. Even 25 chemotherapy cycles (or more) didn't control his cancer in his prostate. Psma pat scan SUV max was 85. Why would you have so many chemotherapy cycles if radiation can control the cancer locally?

[chefjlu]

Diagnosed July 2018 - Biopsy 12 cores, 1 Gleason 6, 5 Gleason 7, 2 Gleason 9 - 1 core showed Perineural Invasion present. PSA at time of Biopsy - 5.889. (Medical Training as I almost became a doctor so I had a lot of information and access) - full discussion after scans with doctors. One scan showed an inguinal hernia. I needed that repaired and elected to have RP at same time - all done robotic. Upon removal cancer Stage 3a - 1 lymph node out of 20 examined showed activity. Primary Gleason Pattern: 4 (60%), Secondary Pattern: 5 (30%) - Estimated percent of prostate involved by tumor: 30%. Extraprostatic Extension found at left posterior. The bigger view showed no invasion of Urinary Bladder Neck, Seminal Vesicle, and no Margins involved by invasive carcinoma. PSA after surgery dropped to undetectable - no other treatment - remained there until November 2022. PET Scan in January showed 1 spot in general area of where prior lymph node removed showed cancer. Scheduled for Radiation, and started Orgovyx (ineffective after 6 weeks) - 1 month Firmagon - then Lupron (6 month shot) - also began Abiraterone. 1 week after end of radiation ended PSA near undetectable - 2 more weeks PSA undetectable. I had very little issues related to RP - I do have to use injection to achieve an erection (no big deal after a couple times) - no incontinence, no pain. Was fully on my feet within a week, some Physical Therapy for hernia and fully working in 3 weeks. Only side effects from ADT/Abiraterone has been mild hot flashes - a bit of fatigue. (exercise regularly, big changes to my diet). No side effects from Radiation other than getting used to having a full bladder prior to treatment everyday and then peeing frequently for the next 2 to 3 hours. I wouldn't change anything - but this was my choice and we're all a bit different. I am comfortable with my doctors and they welcome my input as well as outside 2nd opinions. I have consulted physicians I know at the Cleveland Clinic and my doctors are connected to Roswell Park Cancer Institute.