surgery or not

[Granica4818]

Hello everyone. As I have shared before my husband has a mets tumor on his spine at T9 around the front and some soft tissue was involved. He completed 5 treatments of radiation. He started lupron one week ago. He was in so much pain for a month. MO and the neurosurgeon treated him with several rounds of steroids and other pain meds. Neurosurgeon says he needs surgery to remove the large tumor and relieve the pain.

However this past weekend the pain started to leave. he has finished his meds and is basically pain-free at the moment. Should we do the surgery? or wait to see if the pain comes back? His spine is weak from the tumor, but we don't want surgery if it is not needed. Has anyone else been in this situation? Thank you ahead of time for any input.

[Izzygirl1]

I’m so glad he’s not in any pain now!! Some good news!!

My husband was hurting so much when he was diagnosed that he could hardly walk. He has mets throughout his skeleton and his ribs that were causing him a lot of pain until he started the Firmagon shots… and now Lupron.

Hopefully the doctors and people here can give you guidance on the surgery.

[Granica4818 in reply to Izzygirl1]

Thank you the surgeon seems pretty confident that the pain will return. could cause further damage if left alone , but surgery is a risk as well.

[GP24 in reply to Granica4818]

I would add apalutamide to lupron. This will avoid pain for a long time. You could try to get into the PSMAddition trial as well.

[Izzygirl1 in reply to Granica4818]

I'm hope that the Lupron shrinks it and you won't have to worry about surgery!

[Tall_Allen]

What does recent CT show?

[Granica4818 in reply to Tall_Allen]

one from 5 days ago shows large tumor wrapped around T9 and into tissue. conus mdullaris extends to T12/L1

[Tall_Allen in reply to Granica4818]

But he just started Lupron. Does the surgeon want to wait to see how much Lupron shrinks it?

[Granica4818 in reply to Tall_Allen]

He didn’t say anything about that. The radiation didn’t shrink it at all. I guess we didn’t really realize that Lupron shrinks it as well.

[GP24]

Lupron did its job. I would not get surgery now.

[Granica4818 in reply to GP24]

Thats what I was thinking. Thank you.

[tango65]

The cancer is mCSPC. He should be on Lupron plus one of the new anti androgens, abiraterone, or enzalutamide and see what happens with the tumor in the spine. One will expect it will be reduced in size.

Consider to investigate if he qualifies for the clinical trial of Lu 177 PSMA for mCSPC.

clinicaltrials.gov/ct2/show...

Lu 177 PSMA may be able to reduce the size or destroy the tumor.

[Hidden]

I am not a dr, and i am not as far along to even think about making that choice. If however I was asked to make that choice one of my deciding factors would be “if the radiation/lupron dont do it, would I be healthy enough to have the procedure done later after many months of treatment?”. The next question I would ask is “If I have this surgery will it guarantee that the cancer will not grow back in the same place?”

[Granica4818 in reply to Hidden]

great questions. Thank you we will ask for sure.

[Schwah]

I’d talk to my oncologist to help guide me as opposed to the surgeon. Surgeons like to do surgery. Your oncologist should help you better see the big picture.

Schwah

[NecessarilySo]

I have a similar pain at about T9 or T8 which has been coming and going for years. According to my records, it started in a lymph node in my back, near right shoulder blade, in 2017 and grew toward and then into the spine. I felt that it was penetrating the spine itself and climbing into the cord, and the pain was sharp and slowly growing. It was at about that time that I began to experiment with heat on my pain spots on my back. I took a 2.5 pound barbell, heated it in boiling water to over 150F, then, using a thermometer, waited for the temp to lower below 130. I lay down on a mat with the weight on the floor, wrapped it with cloth, and wearing a t-shirt as well, I allowed the weight to heat my spine as much as I could stand, in the range of 120F. It seemed to eliminate the pain temporarily for several weeks at a time, after which I would repeat the process upon repeat of pain. I believe the heat kills the csncer, or most of it, and part of it survives, even now I feel "something" there. I also take Lupron, so that must help to keep it down. I also take very hot showers at that location if I feel it is painful, and that also seems to keep it down. I never considered surgery. I would think surgery might cause trouble.