Prognostication Requested

[compiler]

My current situation: PSMA scan found 2 hot nodes in the lower

retroperitoneum/para-aortic region. This happened twice before and each time a 3-month or so Lupron shot and SBRT bought me 12-24 free months. So, once again,I was happy that no bone nor organs lit up (always a fear that my scan will light up like a Xmas tree!).

Unfortunately, the joy was short-lived. RO said the area was previously radiated and while he "could treat it aggressively if I so desired" it was clear he did NOT recommend radiating it. I asked what would be the SEs, and he mentioned bowel issues.

So, I am back on HT (Orgovyx). Hopefully, it will dissolve/diminish these nodes.

It was VERY disappointing.

I guess what I'm asking:

1) Is HT without SBRT still likely to put a dent and maybe eliminate those aforementioned nodal spots?

2) Curious what decision you would have made RE: SBRT (FYI I was dx. G 4+3 in 2009; failed surgery and srt but so far responded very well to HT). I do have a multitude of intestinal issues due to IBS, which factored into my decision.

Mel

[GP24]

Orgovyx will reduce the size of these lymph nodes and could make them so small, they will no longer appear on a PSMA scan. I got one Lu177 cycle when I was refused SBRT. This cycle removed the lymph node mets in my case.

[Seasid]

Try hormone therapy first. I am using ADT alone and after more than 4 years i don't have any on the PSMA PET CT scan visible mets. (Only prostate with SUV max 14 and the prostate underwent SBRT).

Therefore save yourself the radiation for later when the met/s will be visible and maybe then radiate the visible mets?)

There is no reason for radiation as far as I can see.

Consult your doctor.

You can maybe use SBRT if and when some of the mets become castrate resistant and visible on the scans. It can be different for each met as far as understand.

[Azores1]

You may want to ask if you are a candidate for cryoablation.