Just wondering…does SBRT continue to drop PSA for any length of time? Or is it five sessions and it is what it is then?
Curious if I can see further PSA reduction after 5 sessions to one node, then 5 to a second node. No prostate.
See the treating RO in a couple of days, but thought I would ask here first.
Thanks. Be well.
If the lymph node mets were detected with a PSMA PET/CT, it will usually take almost a year until new mets appear. Therefore I recommend to get ADT after the radiation. See this trial:
Sharing alternative approach - I looked into SBRT six years ago after imaging identified five suspicious pelvic lymph nodes, but went for (uncommon) salvage extended pelvic lymph node surgery. Cancer confirmed at paraaortic nodes. Six years later usPSA holding very low stable 0.03X range, no ADT.
SBRT should never be used on two isolated pelvic lymph nodes. Lymph is a slow-moving fluid and cancer cells are carried along in it. Those cancer cells are invisible on PET scans or any other imaging. For that reason, the entire pelvic drainage area up to at least the common iliac nodes must be treated, with a boost to the known sites. This has to be accompanied by 2 years of abiraterone and 3 years of ADT to make sure they got it all. During that time, PSA should be undetectable.
First PSMA Scan after 3 months radiation to lymph nodes
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