First Post

[Sam2346]

I have been reading everything I can here, but still feel a little terminology and technically lacking. What would be helpful in helping new members is very very basic terms until they get up to speed. I have several questions. I am gleason 8, de novo, lymph node involvement in pelvic region, and one distant one . On trelstar and Xtandi just over 3 months. Just got first psa since this regimen 0.12. Radiation IMRT to begin in a week. Is this psa okay, will it decrease after radiation? In regard to triple therapy, why is there an advantage to hit it hard initially rather than wait to see how adt and radiation does by way of psa? wouldn't saving chemo until psa rises make sense also? The idea being saving chemo until maybe adt no longer works

[Tall_Allen]

You may find this helpful in explaining the basics:

nccn.org/patients/guideline...

How sure are you about the renal LN? Was it diagnosed from a PSMA PET/CT?

Triplet only works when given all at once, not sequentially. But I doubt you are a candidate based on the single renal LN - the trials included very few patients with lymph node only.

[Sam2346 in reply to Tall_Allen]

I would have to re look at pet scan. RO plans on SBRT to lone lymph node as it was 2 mm from his radiation field for IMRT. However all the details got lost in a swirl of mental overload that day. Will revisit that prior to first IMRT treatment. Thank you for answer and basic info link

[Sam2346 in reply to Sam2346]

psma pet scan that is

[Tall_Allen in reply to Sam2346]

PSMA is excreted by the kidneys so a renal LN is suspicious as a false positive.

If it is a false positive, whole pelvic radiation with 2 years of Trelstar+Xtandi may be curative.

[Sam2346 in reply to Tall_Allen]

All i recall is that it was close to but not an issue as far as sbrt. I would assume when the initial ct scan markers are done that it would still show? How do you best determine if excreted by kidney or not, and by the way, the psa I mentioned, thoughts on that?

[Tall_Allen in reply to Sam2346]

The currently approved PSMA PET radioindicators are definitely excreted by the kidneys.

PSA is low because of your hormone therapy.

[Sam2346 in reply to Tall_Allen]

unfortunately the distant LN is in retrocrural. Some in abdomen also, so no chance on false positive as previously discussed. onwards we go !

[Sam2346 in reply to Tall_Allen]

found some info on urotoday website, will discuss with RO, thank you

[Huzzah1]

If you look at the right side the forum page, you will see the pinned posts - one of them will be PCa Abbreviation List. This list has been very helpful to me during my journey. So much of the stuff we have to deal with have rather long words - thus the initials

[Darryl Partner]

it’s right here: healthunlocked.com/advanced...