concurrent salvage ADT with IRMT

[live2play]

Hello,

1st time caller,

History: RALP - 1/2020, Gleason 7 (4+3), pre treatment psa of 11, psa started climbing 5/2023 to 1.651, was at 2.5 prior to psma/pet/ct on 6/21/2023. Impression: Equivocal small faint focal uptake in prostatetectomy bed and non enlarged left external iliac nodes. Doc at AHN Pittsburgh wants 6months ADT (Orgovyx) started in 8/23 concurrent after 8 weeks with IMRT to the high risk pelvic lymph nodes to a total dose of 45 Gy in 25 fractions (1.8 per fraction) with a simultaneous integrated boost to the prostate fossa/ seminal vesicles remnants to a total dose of62.5 Gy delivered in 25 fractions to start 8 weeks after the start of Orgovyx.

Question: It seems to me that this is only treating the issues at hand and not expanding for future occurrences by zapping the whole pelvic area. Is this the case? I'm new at deciphering terminology and procedures and found this site very informative. Any help understanding where I'm headed is deeply appreciated.

[Tall_Allen]

1) I agree that the entire pelvic area needs to be zapped. This was proven in the SPPORT TRIAL:

prostatecancer.news/2022/05...

2) While SPPORT only offerred short-term ADT, it excluded patients who were already found to have cancerous LNs on a CT. While your cancerous LNs did not show up on a CT, they did show up on a PSMA PET scan. There are no clinical trials where LNs are PSMA-detected only, but the STAMPEDE trial showed that 2 years of abiraterone+ 3 years of ADT +salvage radiation improves results when cancerous LNs are detected:

ncbi.nlm.nih.gov/pmc/articl...

[j-o-h-n]

Greetings live2play............... here we "pray2live"..........

You've come to the right place for help and for information. Good idea to place all your PCA data in your Bio....

As you know Tall_Allen knows his shit..... so heed what he says. Keep posting here.

BTW I am not the official welcoming committee, the ladies are and they'll be by your house one night soon (make sure you send your wife and/or your girlfriend out shopping for shoes)...

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 09/29/2023 6:25 PM DST