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[Jansverr]

I did a PSMA PET Scan Mar.31th and received the results today. I used Google translate and I hope this makes sense.

1. A metastasis-suspected PSMA-positive lymph node medially for the iliac externa vessels on the left side.

2. No evidence of PSMA-positive local recurrence or PSMA-positive metastases in general.

3. Low PSMA-avid tumorload (safe metastases) relative to PSA level.

Secondary findings: Saccular thoracic aortic arterism 4.4cm

PSA is 10,1. approx. 3 months doubling time.

They will inform me on Monday if next step will be surgery or radiation. What is the opinion of the members, knife or beams?

[Tall_Allen]

You need whole pelvic radiation and at least 2 years of hormone therapy to cure that.

[Jansverr in reply to Tall_Allen]

I have been told to continue the Nubeqa and Zoladex and maybe try some other stuff, but my question was what would be the next thing, surgery or radiation? What do you recommend.

My doctor says the will give me the decision on Monday.

[Tall_Allen in reply to Jansverr]

You need whole pelvic radiation and at least 2 years of hormone therapy to cure that.

[Hidden in reply to Jansverr]

radiation

I have a hot iliac lymph node. No surgery.

Too close to iliac artery.

Once lymph node is noted. It’s metastasized, as my MO says. It’s in the blood.

[Derf4223 in reply to Tall_Allen]

#4 APc means metastasis which means it is not curable per se. Low tumor load AKA oligometastatic means good odds of dying from something else. == my case. Don't be afraid of radiation. We live in times where advanced medicines and procedures are available to us at an earlier stage. This has all been paid for by our forebears and I for one want to pay it forward. The medicines and procedures they endured for our benefit had far worse SE's.

If money is an issue (are you on medicare?) and a medicine is available generic -- you might be able to get it for about 1% of its full branded insurance-billed price (see scriptco.com which I use for abiraterone, for example.) Medicare (and my Advantage plan) discount the heck out of doctor visits, injected meds, scans, etc. But not meds that are tier 4 on medicare. For those you get the privilege of stonkingly high copays.

[Tall_Allen in reply to Derf4223]

The APCC stage groups (I-IV) are useful for other kinds of cancers, but are not useful for prostate cancer. We use two metastatic categories: N1 means metastases have only been detected in pelvic lymph nodes; M1 means metastases have been detected in more distant locations. N1M0 may be curable. M1 is not curable with current medical technology. (They are both Stage IV)

The OP is in Norway.

[Derf4223 in reply to Tall_Allen]

I rarely do this -- thanks for the M1/N1 explanation. I appreciate your posts.

[Hidden in reply to Tall_Allen]

Cure? I have a hot iliac lymph node, was told, no cure by 2 MOs

[Tall_Allen in reply to Hidden]

Maybe curative in some cases. There is certainly a survival advantage:

prostatecancer.news/2017/12...

[Hidden in reply to Tall_Allen]

Im hoping!!

In my case, similar to OP

6 months of Lupron/Zytiga/Prednisone _first_, then will start WPRT next week.

The RO wanted to put these little buggers to sleep first!!

[Tall_Allen in reply to Hidden]

2-3 years of hormone therapy are required

[Hidden in reply to Tall_Allen]

Yes, true, what I said was 6 months ADT "first"

[GP24]

"My doctor says the will give me the decision on Monday." At the end of the day, it is your decision. You can get the lymph node radiated with SBRT radiation. Usually no side effects. Or get whole pelvis radiation to treat further lymph nodes still too small to be detected. Continue with Nubeqa.

[Hidden]

you need that aneurism repaired first.

If it bursts, cancer won’t matter.

[PSAed in reply to Hidden]

Well spotted!