T4 with scleratic focus

I had SBRT to L1 T9 and T10 back in july 2021.

A Ga68 PSMA Pet scan from June 2022 showed no activity but identified a metastatic focus on T4 .

A more recent PsmaPet scan from march 2023 showed mild activity small sclerotic foci (0.4 cm.)

Some say have it ablated others say the T4 has only mild activity so take a wait and see approach.

I have been taking zolodex since june 2021

My PSA started to rise in feb 2022 and I started xtandi in june 2022

My PSA is currently 0.4 but this is rising

any advice on what to do next would be appreciated

[Tall_Allen]

This addresses your question:

prostatecancer.news/2022/12...

[Hidden in reply to Tall_Allen]

Geezzz that is depressing I only have a few months left to live, 😞

[Tall_Allen in reply to Hidden]

How did you come to that erroneous conclusion?

[Hidden in reply to Tall_Allen]

paragraph 3 bullet item 6 22months life expectancy for both groups am I wrong on this? I surely hope so. I thought I had a 30/70 chance of making it to 5 years after being diagnosed the stage 4 mets and even at that rate I now have 3 years

[Tall_Allen in reply to Hidden]

Look at the patients- they were all quite a bit more progressed:

• Their metastases were identified on a bone scan, not a PSMA PET scan - that alone is several years lead time bias.

• 60% were originally diagnosed with metastases on a bone scan

• Only about a third had prostate treatment

• PSA>100 ng/ml at some point

• PSA had to be >5 ng/ml at study entry, median=48

• median age = 74

• Many had already had a second-gen hormonal (43%) and/or chemo (30%)

[tango65]

If there is only one bone metastases I would discuss irradiating the met and continue therapy with Xtandi and ADT and see what happens.

[Brysonal]

Hi Ian

I understand 100% the urge for action and I had SBRT to two mets whilst ogliometastic and hormone naive, I really wanted to combine the SBRT with early Lu-177 but hit a number of walls in early 2021 (no Lu-177 here in UK, worldwide pandemic) so I just did the SBRT hoping for the abscopal effect. I wasn’t one who got that impact and those mets (T1 and third rib) resolved but new ones popped up everywhere on spine/ scapula etc.

So ADT it was for me 6 Months later and by that time I had sorted access to early Lu-177 in Finland ( 3 infusions followed by 3 early Docetaxel).

If I could turn back time I would have sorted the Lu-177 myself 6 months earlier but heigh ho. It was out of pocket expense but I chose to throw all at it!

I added Vmat to prostate and pelvic area and 2 x Brachi ( esp controversial) 1 more SBRT to T9 which still showed slight activity

I added Apalutamide and after 7 months of treatment went PSA undetectable and scans showed NED. I am 9months undetectable now but no idea what did what.

In addition I agreed to the OVM-200 cancer vaccine clinical trial at phase 1 ‘first in humans’ and had 3 shots of that in December 22

I think the science is coming and wanted to do what I could whilst relatively fit as I have been asymptotic the whole time.

I ignore prognosis stats. They are medians based on historic data and the landscape is changing all the time so prefer to look forward with a positive frame of mind.

Good luck with what you decide

[Kayakbob]

I would suggest looking into spot radiation for the T4 met before it gets too large! and, you have MUCH more than the 'few months to live' you mentioned. I had lumbar met (with a compressive fracture) show up, and had spot radiation - that was almost 10 years ago. Also had Provenge treatment at the time - worth investigating, also! You have to keep fighting the beast to keep it at bay for a long time - there's no guarantee that you will get a great response, but there is a guarentee that you will get a poor outcome if you don't stay ahead of it!

[j-o-h-n]

The life expectancy for everyone one on Earth's rating from 0 to 10 is 0....As calculated by Chief actuary Mr. What Me Worry for the U.S. Government's office of Weaintgetting. [e-mail]

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 03/31/2023 12:17 PM DST