Radiation?

[Tommyj2]

just got my psa results after my first round of 4 months leuprolide and 3 months Zytiga and prednisone…..initially 18 now 0.04. Nurse told me that my MO would like to see me early to discuss more radiation( recent psma found areas of avidity only in prostate bed……initial tx was 48 grey imrt back in 2014….no ADT. No other tx until recent ADT. Don’t know if I’ve provided enough info for this question…..but would more radiation be of any benefit over ADT? Any “curative” possibility given rapid response to ADT?

[Tall_Allen]

I wrote this when Choline PET was still the best PET scan available for finding residual cancer in the prostate or lymph nodes:

prostatecancer.news/2016/09...

Now, with PSMA PET scans widely available, there is opportunity for a cure by even earlier treatment.

The major questions are:

1. focal or whole gland treatment?

2. External beam radiation, brachytherapy, or thermal ablation. Read this:

prostatecancer.news/2017/09...

3. Treat pelvic lymph nodes anyway?

4. If salvage radiation, what hormone therapy with it and for what duration?

BTW- Your IMRT treatment in 2014 was higher than 48 Gy, but it is helpful that your treatment was so long ago.

[Tommyj2 in reply to Tall_Allen]

Thank you for the references TA …salvage clearly comes at a cost. Wonder what my MO will have to say?