Hi all - just wanting your thoughts on this.
In my profile you would see full details but I will summarize here.
50yr old diagnosed Aug 2nd with PCA with spread to L5 and pubic bone. Original PSA was around 9 and put on Casodex for month, then Lupron every 3 months, plus Darolutamide. Just completed 6 sessions of chemo with Docetaxel.
Got call from RO yesterday and they want to do radiation now. Of course I trust my medical team but curious of HU opinions on this path.
Radiation to where? Prostate or metastasis?
Well, thats a great question. When I originally seen the RO they were going to hit my metastasis to help with some pain I was having. I havent had that pain (knock on wood) since all the other treatments (ADT and Chemo).
So, I guess I will find out when we speak next week. I think the plan back then was radiation to metas and THEN prostate but I could be mistaken - its been a long time now.
Have you had another set of scans performed since finishing the chemo?
I have a bunch of scans upcoming - bone density, nuclear etc...but on the 5th they will do an MRI at the cancer center, then they will do the tattooing so they know where to hit each time.
I enrolled in the EXTEND trial at MD Anderson. After chemo, I had whole pelvis, which I wanted, but then was randomized and they hit the one spot on the spine. I believe in killing the mothership.
yeah I like that thought too - lets hit this with everything we have right?
Your age and diagnosis are somewhat similar to mine. I followed a similar treatment path to what you are currently on including adding radiation after chemo. One difference is that I did have my prostate removed. Since finishing radiation, I have maintained an undetectable PSA for 2 years and continuing. I am currently taking eligard and zytiga but will be discontinuing zytiga soon. I think you should be encouraged that you are on a good treatment path and I think you will get many years of good results from it. Stay strong brother.
My story similar to yours. I have an aggressive treatment team at Johns Hopkins. ADT, chemo, Darolutamide, RP, whole pelvic radiation and radiation to single bone met at T8. No off all treatment and PSA undetectable. I believe in trying to kill all visible tumor with radiation, assuming number of mets is <5.
You are off all treatments? Were you metastatic?
Nuttin like giving the old fucking Pca a zinger!!!
Good Luck, Good Health and Good Humor.
j-o-h-n
it's going to SBRT. Darolutamide + SBRT radiation is a great choice. Try to get PSMA PET scan and find out total spot.
Triplet Therapy for HSPC
PSA .03 after Radiation and ADT
Pain and Radiation 
