PSMA Results

[Cancer2x]

Well, PSMA Pylarify scan yesterday was basically unremarkable EXCEPT for the following:

Lymph Nodes: New radiotracer avid subcentimeter right common iliac node (image266) and a subcentimeter right pelvic sidewall/obturator lymph node (image 295).

IMPRESSION:

PSMA avid right common iliac and right pelvic sidewall/obturator lymph nodes are most likely active metastasis and reason for Rising PSA.

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Hmmm… SBRT perhaps? Some drug(s)? Do nothing at this point? (Besides Bourbon, of course.)

[Tall_Allen]

Could you please supply some info in your profile?

[Cancer2x in reply to Tall_Allen]

Sure, TA!

Open RRP May 1996! Dx’d at 48, RRP at 49. PSA 10.8, Gleason 3+3 =6, restaged to 12.0 post Unilateral Nerve sparing (HA) surgery.

No erections nor orgasms since surgery.

Recurrence noted in 2005 (9years later!)

No treatment, SLOW PSA climb to 0.90 two weeks ago.

Axumin coupla months ago - showed nothing.

PSMA Pylarify yesterday - two tracer positive lymph nodes.

Been a long time. Next?

[Tall_Allen in reply to Cancer2x]

Next is whole pelvic radiation and hormone therapy. Consider joining this clinical trial:

classic.clinicaltrials.gov/...

[Cancer2x in reply to Tall_Allen]

Whole pelvic radiation seems a bit extreme based on two small loci? Why not SBRT to the two locations and wait and retest?

[Tall_Allen in reply to Cancer2x]

You do not have two small loci. You can only see two small loci. When cancer metastasizes from the prostate, millions of cells are released. They often get stuck in lymph nodes that drain the prostate. There, they can multiply and spread. Some grow big enough to see on a PET scan, but most are in much smaller clumps, too small to see (under 5 mm). You have to treat what you cannot see. And the last thing you want to do is wait - that is a self-fulfilling prophecy: if you wait, they will grow and spread.

Lymph is a slow-moving fluid that carries cells around. But unlike blood (which carries cells to bone and other distant places), cells may get caught in the nodes and avoid systemic circulation. It is your last chance at a cure.

[Cancer2x]

Thanks TA! Meet with the MO today. I’m thinking that radiation plus hormonal therapy and maybe even triplet therapy may be the way to go at this point. The PEACE-1 Trial had some interesting data.

I read, (but can’t seem to relocate) a trial that showed military Veterans had a worse set of adverse effects/outcomes with Abiraterone over Enzalutamide. Like WAY worse! Just found it. Will discuss it with the MO.

PS:, Will ALSO discuss the clinical trial you sent info on. They are running it at Dana Farber also. Maybe still recruiting.

Thanks for all that you do for all of us, TA! Sometimes all we need is to be pointed in the right direction.

Stay well yourself!