Lymph node treatments: Recent CT and... - Advanced Prostate...

Advanced Prostate Cancer

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Lymph node treatments

Ian996 profile image
8 Replies

Recent CT and PSMA pet scans show mild progression of activity in right superior paratracheal node ( SUV Max 3.2 in march 2023 vs SUV max 2.1 in june 2021) and right Hilar node SUV max 5.5 in March 2023 vs SUV Max 4.6 in June 2022)

what can or should be done about this?

Note my PSA has risen from 0.27 in November to .49 in April

I started Xtandi in June 2022 when my PSA was 0.69 and it quickly dropped to 0.40 in July

but has slowly but steadly climbed back up

Is the rise in PSA a result of this mild progression of disease in the lymph nodes or resistance to Xtandi

Back in 2021 I had SBRT to mets on my L1 T9 and T19 vertebrae and they are stable

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Ian996 profile image
Ian996
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8 Replies
GP24 profile image
GP24

There is no proof yet that it will result in overall survival but you can radiate these mets with SBRT. You could wait until additional ones show up.

Tall_Allen profile image
Tall_Allen

I don't think that focusing on visible metastases at this point does anything to benefit you. Systemic treatment gets what you can't see as well as what you can see.

jbskiatook profile image
jbskiatook in reply toTall_Allen

What is systemic treatment?

jbskiatook profile image
jbskiatook in reply toTall_Allen

Please ignore that question if I had read further down I would know thank you

tango65 profile image
tango65

With bone mets and lymph nodes mets in several places the cancer is disseminated in the body.

The cancer is mCRPC resistant to enza and most probable resistant to the other new anti androgens.

Systemic therapy with chemo, (docetaxel ) or with Lu 177 PSMA, should be discuss. There are clinical trials for Lu 177 PSMA without having chemo.

You could also discuss Provenge a vaccine which has shown to prolong life.

john205 profile image
john205

My PSA is also rising slowly, but should not necessarily be considered failure until it gets close to 2.0. As a next step, consider chemo. Another possibility is a PARP inhibitor like olaparib, if you have a BRCA gene in your tumor tissue.

NecessarilySo profile image
NecessarilySo

I would assume that there is growth of APC. The locations in the neck and clavicle areas are good for heat treatment with very hot showers.

slpdvmmd profile image
slpdvmmd

Consider radioligand therapy. May not be eligible in USA but could be done overseas. Could couple this with external beam.

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