Is this decision right for me

[old64horn]

I had a PSMA pet scan on 7/16/2024. The result shows a single tumor in my left lung measuring 8mm. My MO wants me to have the tumor radiated and monitor the PSA and its doubling time.

A little background, I'm just short of 83 years old. I had prostatectomy in 2009, PSA undetectable until 2017. I had radiation in 2021 to the prostate bed when PSA reached 0.12.

0.12 on 4/28/2021

0.65 on 04/04/2024

using the above values shows a doubling time of 14.4 months. The latest PSA on 06/11/2014 jumped to 1.06.

My MO wants to treat the PSA and see if radiating the tumor will reduce the PSA to a very small number (<0.1) and monitor the doubling time. If it is less than a year then it is time for ADT.

My situation is special because I have had too many health issues in the last couple of years. A cystectomy in 01/2023 due to bladder cancer, one year of immunotherapy with Opdivo, and back surgery for sciatica in June 2024 in addition, I now a hernia under the stoma.

Am I making the right decision? your help is appreciated.

[Tall_Allen]

"My MO wants to treat the PSA and see if radiating the tumor will reduce the PSA to a very small number (<0.1) and monitor the doubling time. If it is less than a year then it is time for ADT."

I agree with your assessment that your MO would be treating the PSA and not the cancer. Only systemic therapy can treat the cancer.

[old64horn in reply to Tall_Allen]

Thanks for your reply. I appreciate and value you opinion, I think my MO is trying to delay the effects of ADT because of all the other health issues I have. I will be starting radiating the tumor the end of this month and finishing it in 2 weeks. It would be nice if the PSA will drop to a low level and maintain a long doubling time.