What is Next? Dx 07/2022 PSA 942.40 c... - Advanced Prostate...

Advanced Prostate Cancer

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What is Next? Dx 07/2022 PSA 942.40 current 0.24 Starting 5th cycle of Docetaxel Chemotherapy, Discuss Radical Prostatectomy or Radiation?

Shorehousejam profile image
7 Replies

Currently on Firmagon, Zytiga with Prednisone, Vit D, Metformin

Will be starting Otelza for very severe made worse by ADT plaque psoriasis

From what I heard there are some clinical trials and cancer centers/hospitals conducting surgery, radical prostatectomy for men with advanced metastatic prostate cancer with less than 4 Mets …

Please share your insight

If Radical Prostatectomy is not possible, is radiation next?

I read somewhere it should of been done first or with chemotherapy for better results, anyone have any information on that?

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Shorehousejam profile image
Shorehousejam
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7 Replies
Tall_Allen profile image
Tall_Allen

It is standard-of-care to treat the prostate with radiation (called "debulking") if there are less than 4 metastases on a bone scan/CT:

prostatecancer.news/2018/09...

There are several ongoing clinical trials linked in that article to see if prostatectomy can give equal outcomes. It also discusses the small Dai trial that suggests surgery may work as well.

Shorehousejam profile image
Shorehousejam in reply toTall_Allen

Thank you

Also found this information

eu-openscience.europeanurol...

Tall_Allen profile image
Tall_Allen in reply toShorehousejam

Be careful about making decisions based on retrospective studies.

EdBar profile image
EdBar

I had my prostate radiated (debulked) 8 years ago and I had widespread mets. I followed that up with chemo per CHAARTED. I’m coming up on 9 years since dx and my PSA only recently became detectable again, going in for a PSMA scan next week.

Ed

Shorehousejam profile image
Shorehousejam in reply toEdBar

That’s wonderful news, thank you

slpdvmmd profile image
slpdvmmd

Sounds somewhat similar to my course. I followed up with radiation. My regret is that I did not have a PSMA scan when all the conventional therapy was completed. I think this should be done after completion of chemo and radiation.

Shorehousejam profile image
Shorehousejam in reply toslpdvmmd

I totally agree

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