Radical prostatectomy in 2003 with PSA of 3.9. PSA slowly rose to .07 in 2023. PET scan in May, 2023 found nodules in my lungs with the largest being 1.4 cm. Needle biopsy identified it as metastatic adenocarcinoma from prostatic origin. 5 sessions of 50Gy cyberknife treatments on the 1.4 cm nodule. As of September, 2023 my MO has me on Abiraterone 1000mg, Prednisone 5mg, Eligard shots quarterly. No bone lesions or lymph node involvement has been identified on additional CT and PET scans at this time. I'm fully aware that distant metastasis to organs without bone or lymph node involvement is rare so I'm working under the assumption that it will show its ugly head at some point. Is there anyone on the site that has a similar diagnosis that can give me their history? Current PSA is now <.01.
Metastatic prostate cancer in the lungs - Advanced Prostate...
Metastatic prostate cancer in the lungs
Even when rare and scary, it seems that pulmonary only metastases in mCSPC can respond well to ADT and anti androgens and have a long survival. They can lso respond to actionable mutations if present.
ncbi.nlm.nih.gov/pmc/articl...
Discuss doing genomic studies to determine if there are actionable mutations.
Thanks for the link. I'll discuss it with my MO.
Best of luck!
The only good news is that lung metastases have been found to be about equally prognostic as bone metastases and not as prognostic as liver metastases.
Thanks. I always look forward to reading your replies. It was quite a shock for it to show back up 20 years after my radical prostatectomy with, supposedly, clear margins and no lymph node involvement.
All it takes is one errant cell. Researchers think that it takes so long because cancer first prepares the "soil" in which it can grow. In 1889, Stephen Paget put forth the "seed and soil" hypothesis: the cancer (the seed) thrives in "congenial soil." Not only does the seed find such soil, we have since learned that it actively creates its soil. It can take years to prepare the soil. That's why metastases appear exponentially - very slowly at first, but speeding up after the soil is prepared.
Recurrence after many years not that uncommon. Believe disease is systemic at diagnosis. Experienced recurrence after 13yrs undetectable, then slow rise. After 7 yrs of active surveillance at PSA BLOWOUT. Major cancer clinic "I don't believe this will bother you in your lifetime".
New clinic treatment now. Relugolix and Xtandi with undetectable testosterone and PSA .05 a month ago from 120.
Only symptom, and not sure fro PCa is severe dyspnea upon slight exertion (anyone else with shortness of breath).
Now recent bone Mets and positive to pet scan nodes. This all came about in last two yrs after perineal RP 29 yrs ago.
Seed and soil?? Here
Thanks for your comments. They reinforce Tall_Allen's comments. I may be going down a similar path in the future. My PC has never thrown off much PSA (3.9 before radical prostatectomy, Gleason 3+4) . Now it's metastatic in my lungs at .07. You get a false sense of security relying on that number. Hope all goes well for you in the future.
Yes, but slightly different. At diagnosis in 2019 , lung ,bone and lymph node metastasis was discovered. Started immediately on eligard, zytiga and prednison. The "inumerable" lung masses averaging 1,1 centimeters in size, were nearly undetectable a year later. So this treatment seems to be very effective at treating mets. Good luck in your journey
Thank you for responding! That gives me a better idea of what to expect.
Wow surprised but thankful you shared ..they always mentioned cure after x number of years .. in my mid 50s I’d be happy for 20 years .. and you for sure have many many more .. would be good to hear what you did over the last 20 years that many people never get a chance to do.. I’m in the 1st year of discovery and treatment and it’s so so .. we all have to be thankful for the time we have as it’s all finite. Just knowing is a grace as it gives us some time to prepare. I wish you the best as I do all of you reading this .. be positive and don’t worry everything will be ok!
Thanks. I hope your journey improves over time. I'm 72 now and only 5 months into mine. You asked about what I've done over the last 20 years since my prostatectomy. It made me stop and think about it. My wife and I were residential home builders which we continued for 10 years before retiring. We traveled across much of the U.S. in our travel trailer, did a rim to rim hike of the grand canyon, sailed through the Panama canal and took a trip to Ireland. Do it while you can and enjoy life.
remotely similar. 2020 dx. Pirads5, PSA 40. needle biopsy 100%. No surgery, 18 months of eligard, erbt with boost in 2021. PSA still .01, but had cabg x6 march of 2023. 64 years old this year, maybe. Wishing I did not do eligard/lupron depot.
Thanks for responding. I'm not a fan of the drug side effects either but that's the world we live in now. Stay positive.
I cannot understand your reply but I would like to know why you regret taking Eligard.Can you please refrain from using anagrams.
My reply, and my existence is not important. I’m sorry to have offended or not met your expectations with my reply. I feel certain that somehow I deserve to have prostate cancer and major heart disease.
Lupron. In 3 days time after the first 3 month injection I had NO testosterone, no desire, no libido, body parts shrunk to less than half size, and my mental health had fallen lower than at any time in my life. Of course I’m told I’m still castrate resistant whatever that means. My prostate cancer blood tests still show no signs of reoccurring cancer. Testosterone shows no sign of returning. I’m not certain that the prescribed gold theory that testosterone causes prostate cancer is helpful to anyone suffering with the disease.
I choose to currently think the theory wrong, because if it were true every adolescent male would have prostate cancer (yes I also feel that a part of what defines male and female is that no female in history has suffered prostate cancer). I have read some of the most anagram filled posts on this forum, most of which I still have no understanding of. It does seem most of the people here prefer to know a short albeit somewhat cryptic anagramatical“ sketch of metrics to diagram ones’ journey, or perhaps qualify someone as having actual real life experience with cancer.
Again, I apologize for anything I replied with that got somehow beyond the pale of expectation. I wish only the very best of everything for all others. I seldom reply to forums of any kind. It seems to have been one more of the millions of mistakes I’ve made, the first of which was apparently being born.
I appreciate responses from everyone. Please continue to contribute when you think you can help someone. I read comments daily from this site to gain as much knowledge about different ways to fight this disease. As I said before, stay positive and continue to live your life. Don't let this disease beat you.
Thank you for your prompt and elucidating reply. Please don't be offended. I am new to this site and cancer as well. Many of the replies are filled with acronyms and I find them confusing . I wish everyone would take the time to write a clear response as you just did and avoid the use of acronyms so as not to confuse and frustrate newcomers to the site. Thanks
Cheez987, the worth of our existence is not up to us to decide. Being alive means God still has plans for us. I have two mantras -- the first applied more during early treatment -- biopsy, radiation, fear of the unknown, side effects -- "Suck it up buttercup." Now on LT ADT, my mantra has turned to "Why not?". It obviates a lot of stress from daily life.
For any God h8ters, there is no need to reply.
I ran into someone this past weekend who clearly thinks he is smarter than his PCA doctors. He had PCA some years ago, RP, and rejected ADT afterwards. Rinse and repeat 2 times -- recurrence and RT. I have no idea how many or where his mets now are (didn't ask), but he is on ADT. He said he relies on a belief system based on wishing real hard for something to happen. I suggest one doesn't let them be that guy.
Really enjoyed the soil and seed discussion. I have an acquaintance who had surgery on his prostate some 20 years ago and thought he was cured but it came back via rising PSA.
I need to follow up to see how he is doing.
As I've posted before....... A Melanoma on my neck eventually metastasized to my lungs and I was treated with Keytruda (immunotherapy) and it worked....... Ask you doc....
Good Luck, Good Health and Good Humor.
j-o-h-n
Was your PSA undetectable after surgery? You said it rose slowly, but from what level?
Thanks.
Yes, I should have stated that. It was <.01 for 10 years then started rising slowly over the next 10 years to .07. I recently changed to a different urologist who felt we should do a PET scan even though the PSA was still low. I thank him for that.
Wow, that is so long. It's good that you kept getting PSA tests after so many years with no recurrence. God Bless you!
I had one node appear on my 1st pet scan, but my PC was contained, they said, in the prostate with no other evidence. I was told it was unlikely cancer because there is no other evidence of travel through to lymph system or other organs.
I see the pulmonary Dr. next week. Finished radiation, still on Eligard (5 of 6 months). No PSA at last test. Can you describe the needle biopsy of the lung? Yours seems pretty small (1.4 cm). - about like mine, Hard to find? Kind of worried about that one.
Many lung nodules are benign so I hope yours is. A 3 cm nodule is technically called a mass so mine was half that. Unfortunately it had a spiculated form which made it suspect. The needle biopsy was done using a previous CT scan to guide them. My nodule was in the right upper lobe. They went through my 2nd and 3rd rib under my right arm piercing the lung to obtain their specimen. Of course they do it under anesthesia. I might add that a pulmonologist initially tried obtaining a specimen by a bronchoscopy. They run a camera down your throat into the lung. It was unsuccessful. They couldn't reach it; therefore, the reason for the needle biopsy. I might add that I have no lymph node or bone involvement showing on my PET scans either. Not trying to scare you but want you to have that information when meeting with your doctors.
Thanks.
Hi S4. I won’t repeat my entire history here but had radical prostatectomy 11 years ago, followed by 37 radiation sessions. Have been on ADT since, mostly Lupron. Discovered the mets were in my lungs about 4 years ago. Began Pluvicto this year. Have had 4 of the 6 infusions so far. Latest scans indicate some shrinkage of the mets. I feel very fortunate. Hope you do as well or better! God speed.
Great to hear you're doing well with your treatmemts. Thanks for responding. I do feel very fortunate now that I've had time to wrap my head around this new diagnosis. My first reaction was anger and sadness but I've turned the page and now reflect on how fortunate I've been. I'm 72, been in good health most of my life, have a supportive wife of 51 yrs, two successful children, and 4 wonderful grandchildren all halfway through college. Can't ask for much more than that.
What prompted your doctor to order the PET Scan.
I had RP in 2011 with 2 subsequent relapses beat back with radiation and Lupron. PSA <0.1 since 2019. Off Lupron since 2021.
Glad you're doing well. This was my first appointment with this urologist. We discussed my history and he asked me if I would like to have a PET scan just to see what might be going on. I said yes. He told me later that he hesitated offering it since my PSA was just .07. Glad he did. My previous urologist wanted to do salvage radiation to the prostate bed when I was at .05 without running any scan. I refused and changed doctors shortly thereafter.
S4: did you have any pain or other symptoms like coughing or hemoptysis from the newly discovered met in the lung?
None at all.
Hello S4, I have prostate cancer in my lungs; you can review my profile for more information if you wish. There is another gentleman going by the moniker chips1942 who also has lung lesions like us, if you want to contact him.
I began Docetaxel chemo treatment just 10 days ago as the Lupron and Xtandi hormone therapy I was on stopped working and new growth was diagnosed. I no longer take Xtandi, but will continue receiving Lupron injections indefinitely as part of the "standard protocol"
Thank you so much for responding. Our paths seem very similar except I was Gleason 7 (3+4). My MO told me there wouldn't be any breaks in my treatments until they quit working. She used to do six month breaks for patients only to have lesions, such as bone Mets, show up. How many and what size of lung Mets were you diagnosed with? Did you have any radiation?
Innumerable lung mets were diagnosed. Initially the largest was 1 centimeter, but as the ADT became less effective, it grew to 2 cm. I agree with your MO's approach, as o believe my "vacations" resulted in the lung mets. The only radiation I received was at the prostate bed after my prostatectomy.
Mets in both lungs, lower lobes. Psa 327. Waited till Psa hit 5664 and started Lupron. Had scans 15 months after starting Lupron and Mets resolved. Never had any symptoms from lung Mets but bone Mets were a different story. No other treatments except 30 days of Casodex for tumor flare when I started Lupron. Abi added 5 months ago, Psa 1.2 and dropping. God bless.
Looks like you had good success with your treatments. I'm suppose to get a scan next week. Looking forward to the results. Hope the results from your treatments continue to go well.
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