Para Aortic Lymph Involvement

[JolleySprings]

Has Anyone had experience with radiation to the para aortic lymphs?

if so, what type?

UCSF says SBRT

Texas Oncology says Proton Beam.

Thoughts!

Thanks!

[Big_Mcc]

Proton beam. More precise

[GP24]

With SBRT you can radiate a smaller area and you just need up to five sessions. I would choose SBRT.

[6357axbz]

I had my entire para-aortic string radiated. Psma scan showed tumors at either end so my RO at MD Anderson radiated the entire string. It took 28 sessions. I think IMRT.

[JolleySprings in reply to 6357axbz]

Did your PSA go down after radiation treatment?😳

[6357axbz in reply to JolleySprings]

My PSA was already undetectable when I had RT for 3 bone Mets plus the PA lymph node string. I had stopped ADT and allowed it to rise to 0.5 to get a decent PSMA SCAN (at UCLA). Then immediatly went back on ADT. Had my RT to Mets about 4 months later.

[JolleySprings in reply to 6357axbz]

my hubby’s PSA even while on Lupron & NUBEQA steadily rising! 3 PSMA scans in one year showed NED. Had CT scan with contrast a couple weeks ago and show Para Aorta invasion on one node at this time. But that is all that is visible! Wondering if that one spot could produce a PSA up to 17!!!!!

Oncologist now says no longer treat PSA… but now treat what’s on scans. 🤦‍♀️🤷‍♀️😩

Will be having Proton Beam treatment soon. Praying it pushes things back for a while!

[85236442968]

JollySprings

Most of my lymph node involvement was in my pelvic lymph nodes. I did have 2 in the Para aortic area that lit up on a PET scan,

Ended up with the 5 SBRT teatments.

It has been about 6 weeks bow since final treatment (28 +5).

Post treatment PET scan scheduled for April 8. I will post about the results.

[NanoMRI]

I chose salvage lymph node surgery over radiation, which included the taking of para-aortic nodes. That was six years ago - usPSA holding stable 0.03X range last two years, no ADT, no chemo. My diagnosis was in 2015, G 4+3, choose radical prostatectomy, post RP nadir also 0.05. All the best!

[God_Loves_Me in reply to NanoMRI]

Hello Who does salvage lymph node surgery ? I may need consulting help in future so just prepare myself to see dr.

[NanoMRI in reply to God_Loves_Me]

hello, six years ago when I chose to have this procedure I came to learn it was an infrequent procedure here in US and I suspect this is still the case. I traveled from Texas to Belgium to have this done, and specially with the frozen section biopsy during the surgery. If you would like additional information let me know. All the best!

[Tall_Allen]

One patient I know had IMRT (25 treatments) with boosts to known sites, one had SBRT (5 treatments). The man who had IMRT was very skinny so we were worried that there was no fat to shield his bowels, but he was OK. Now that Viewray MRIdian is back, I prefer that because they can contour the bowels to prevent dose to them.

[JolleySprings in reply to Tall_Allen]

Never heard of it… sounds interesting. Did a brief google search and it appears to be in bankruptcy. 🤷‍♀️

[Tall_Allen in reply to JolleySprings]

No. They were rescued.

[JolleySprings in reply to Tall_Allen]

Awesome!!!!! It sounds like a Very Viable and Specific Intervention which is Soooo needed!

[Mcrpca]

My husband had cyber knife treatments at Swedish Hospital. Not painful although required some anti-anxiety meds to keep him still. Can’t say I was impressed with the outcome.

[tayninhtom]

I had IMRT, but today, proton or SBRT is more precise and less damaging to surrounding tissue.

[Bowmaster]

Good day . I am having a problem with my limph nodes on my neck now for two weeks and they tell me the problem is the drugs I take for the hormonal therapy . I am getting some kind of alergic reaction and the other day I past out on the street with + 40 temp which almost killed me . The Doctor told me to stop the drugs right way but I have an implant in my stomach to control the PSA which can not be removed . Now I too wonder what to do next . Good luck to you anyway .

[Stereo1]

I just finished. I had radiation from a CyberKnife device IGRT (image guided). I had 35 sessions. It was not SBRT, at least for the first 25 sessions. The last ten included a 10 session “boost” and five other sessions (these were given to me at the same time - machine stopped and then a few seconds later started the second round) to go over another area. They covered my upper abdomen and the pelvic floor.

Oncology tested PSA with two sessions remaining and it showed <0.0. I was PSA 35 post op and had to wait for six months post op for radiation. Hormone therapy brought it down to .9 just before radiation.

It all went fine. A little diarrhea started around 3.5 weeks in and already resolving at just one week past last radiation.

Good luck in making your choice. I think the recommendations are based, in part, based on the equipment and capabilities the radiologist has access to.

[wilcoxsaw]

Have had proton beam treatment to specific lymph nodes that have lit up on a psma on three different occasions since 2017. 15 treatments the first time, 15 treatments the second time, and five treatments the third. Each lymph node was different and in a different area. Zero side effects because of the unique physics of the proton and its ability to spare healthy tissue from exposure.

[God_Loves_Me]

I am taking SBRT right using proton therapy. I am NOT dr my understanding is radiations dr use proton machine to deliver SBRT treatment to patient. I have still 5 session to complete

[God_Loves_Me]

my questions is can I do SBRT again after 1 year or later stage for different spot ?

[RCOG2000]

tomotherapy. Psa dropped to .08.