Lymph Node Irradiation for a Potentia... - Advanced Prostate...

Advanced Prostate Cancer

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Lymph Node Irradiation for a Potential Cure

TuffNuttoCrack profile image
23 Replies

I have read that some men have been cured from earlier posts that I have read. Currently I have been on abiraterone and Lupron for 21 months. I only had one docetaxel, before catching pneumonia, so chemo was halted by my oncologist, stating the chemo would kill me before the cancer.

The one chemo and abiraterone and Lupron shrunk the lymph nodes by 75 percent over time. The lymph nodes affected are a distal left iliac measuring about 1 cm, left pelvic sidewall 2 by 1 cm, another left pelvic sidewall 1.5 by 1 cm, and a para aortic lymph node 0.7 cm. I did have a pelvic lesion but it is now considered to be treated.

In talking with a radiation dosimeter specialist from a state medical university center, he said they irradiate lymph nodes all the time, takes four to six weeks of treatment.

I would like to know from those who have been cured if there is a possibility for a case like mine to have a plan of care that would involve irradiation of the lymph nodes and prostate surgery or proton radiation. When I approached my oncologist last with this idea, my understanding was that it couldn't be done due to my cancer being high volume. I hope something has changed due to the bone being "treated". I got to tell you there are days like today for example, I just go into total exhaustion early from doing the simplest thing like patching some stucco trim in the heat.

Thank you

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TuffNuttoCrack profile image
TuffNuttoCrack
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23 Replies
Tall_Allen profile image
Tall_Allen

As far as we know, cure is impossible once there are bone metastases. It does not matter that the bone met is now undetectable. There are many smaller ones that are below the limits of detection by imaging.

TuffNuttoCrack profile image
TuffNuttoCrack in reply to Tall_Allen

I see, thanks for your insight, Tall_Allen. We will just have to pray that nothing else shows up. Thank you.

TuffNuttoCrack profile image
TuffNuttoCrack in reply to Tall_Allen

youtube.com/watch?v=04crGGf... Do you have an opinion about their work as far as presenting information about Advanced Prostate Cancer.

Tall_Allen profile image
Tall_Allen in reply to TuffNuttoCrack

I don't think there is any info worth a patient seeing in a youtube video. I don't look at them. If a doctor has something worth publishing, it will be accepted in a legitimate peer-reviewed publication.

Retireddoc profile image
Retireddoc

Statistics about long term remission or even "cure" lag current treatment. When trials are conducted and the results are obtained, the treatments utilized are years old. The long term remission rate for current aggressive treatment for oligo metastatic prostate cancer is not yet known as enough time has not elapsed.

Knowledgeable, aggressive Medical Oncologists at COE are treating low volume metastatic disease with triple therapy (chemo, ADT and anti androgen receptor drug) plus either RP (to remove primary tumor and its interaction with distant metastases) or prostate RT plus MDT (radiation to know bone/LN mets) plus pelvic radiation.

There has not been enough time elapsed since beginning this more aggressive treatment to know if a percent of patients will have long term remission or even cure. There is evidence in the literature that radiation of metastases stimulates the immune system to attack micro metastasis. Early reports from Johns Hopkins regarding Total Eradication Therapy (TET) are encouraging.

Tall Allen is right; if you have one or a few bone metastases there are more micrometastatses lurking elsewhere below the level of Imaging detection, even with PSMA PET.

But, if you continue to treat any bone/LN mets with radiation as they arise (whack a mole) you can prolong survival. How long? Nobody knows.

Mascouche profile image
Mascouche in reply to Retireddoc

I was not familiar with TET. Thanks for bringing that up. Found these articlse about it: bmccancer.biomedcentral.com...

link.springer.com/article/1...

nature.com/articles/d41586-...

umms.org/health-services/ca...

vintage42 profile image
vintage42

"... they irradiate lymph nodes all the time, takes four to six weeks of treatment. I would like to know from those who have been cured..."

After biochemical recurrence and a scan found cancer in one node, I had six weeks of IMRT to the pelvic lymph nodes with focus on that one. It was not presented as a cure. The RO said it would treat the one node and tamp down undetected cancer in the rest of the pelvic nodes. The MO said it might hold off mets for a year or two.

cigafred profile image
cigafred

Many years ago I had 8 nodes (para-aortic and common iliac, 4 to 9 mm) irradiated. Did not seem to make much difference. On the other hand, after taking a boat-load of supplements, I then got down to undetectable for a number of years while on first line ADT. Only the last few months have I had PSA readings of .02 and .03. No idea of the radiation helped. More details in my bio.

TuffNuttoCrack profile image
TuffNuttoCrack in reply to cigafred

its good to meet another Fred except under these circumstances. Thanks for your information. Also for anyone who wants to know effects of being without abiraterone more than a day; I went 16 days without as they won't let you have it in the hospital. So tomorrow we will hope the PSA is less than the reported detection limit of 0.1. When I first started treatment my PSA was very low for my extremely aggressive cancer at 2.4. With Lupron and abiraterone it went to less than 0.1 in a couple of months after diagnosis.

NanoMRI profile image
NanoMRI

Salvage extended pelvic lymph node dissection with frozen section pathology method was my choice to remove remaining tumor burden identified by imaging; was NED in bones. Six cancerous nodes including common iliac and para-aortic confirmed. That was over six years ago. All the best!

TuffNuttoCrack profile image
TuffNuttoCrack in reply to NanoMRI

Thank you for adding hope! At least you have proven its feasible depending on the oncologist. I sent them a note regarding the lymph node irradiation during the 16 days I was in the hospital. My wife and I may get answers tomorrow.

NanoMRI profile image
NanoMRI in reply to TuffNuttoCrack

Hope with a bit of 'science' behind it has served me well; so far. My lymph node surgery did not have the support of oncologist - several I consulted with held to common practice of ADT (STAMPEDE trial). It took some looking to find urologist to support the surgery.  

Still_in_shock profile image
Still_in_shock in reply to NanoMRI

We know!!! But many if not most can not afford to fly to EU for that,

NanoMRI profile image
NanoMRI in reply to Still_in_shock

I certainly appreciate money is a consideration. I came to learn Mayo Clinic here in US offers this procedure - would still require travel for most. Regarding costs, health care in much of Europe is quite (shockingly) less as compared to US; I have had two surgeries and multiple imaging methods done. I lived and worked there at the time of my diagnosis so I had a better understanding of it all. That said, I save for rainy days and have always lived below my means to have funds for the rainy days. My multiple treatments in Europe, inclusive of all costs, well below the cost of say a fancy retirement vehicle (no Corvette for me). All the best to all of us!

TuffNuttoCrack profile image
TuffNuttoCrack in reply to NanoMRI

How do you get into Mayo without your oncologist referral? Also, the procedure as I understand it is done by University of Florida routinely.

NanoMRI profile image
NanoMRI in reply to TuffNuttoCrack

I know several men who have approached Mayo directly, and been accepted - I have not so I have no personal experience with Mayo. Did a brief search on UoF, did not find any information on this procedure. This is what Mayo has - mayoclinic.org/departments-....

Mgtd profile image
Mgtd

No studies to add to support this but my RO suggested that we treat the pelvic area with radiation while doing the prostrate. This was really to possibly get to small amounts not visible. Honestly sounded like reasonable approach.

Did it work? Only time will tell and I got two procedures for the price of one. How many ROs do you know that offer BOGO?

TuffNuttoCrack profile image
TuffNuttoCrack in reply to Mgtd

Again another piece of good information to present to my oncologist. From what I have been reading is that even though a spot has been "treated" the bone lies dormant for a while and then it may flare up again. Thats why I honestly found Tall_Allen's information devastating when you see the morbidity statistics of those with bone cancer, but you call em as the science presents. Still I have faith for a cure. Thank you.

NanoMRI profile image
NanoMRI in reply to TuffNuttoCrack

the stat's were against my chosen method, but then, they are just stats that need careful, broad understanding. As individuals and strong self-advocates we can make our own stats.

j-o-h-n profile image
j-o-h-n

When you have some free time and you're not exhausted.......I have some stucco trim that needs painting. Free can of coke.........

Good Luck, Good Health and Good Humor.

j-o-h-n

TuffNuttoCrack profile image
TuffNuttoCrack in reply to j-o-h-n

Stucco mix yesterday, painted-today …you’d never know unless you looked for it. We have stucco guys working in neighborhood but I’d have to walk a mile to get somebody for a 50 buck repair but I had already bought the mix from the inter-not!

Stucco Repair
TuffNuttoCrack profile image
TuffNuttoCrack in reply to j-o-h-n

John I had to lay the surface back and expose the styrofoam and use a special styrofoam glue caulk to glue the two styrofoam surfaces together that had been damaged. I know you are really into this!

j-o-h-n profile image
j-o-h-n

You convinced me, I think I'm gonna move............

Good Luck, Good Health and Good Humor.

j-o-h-n

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