Proton Therapy Had PT Therapy 15 years (2009) ago 5 year follow Up No Cancer Just Diagnosed with Mets in Bone/Pelvic Lymph Nodes in 2024

[Rcole727]

Had PT Therapy at MD Anderson 15 years ago with Pencil beam radiation. Gleason at the time 2009 was 6 (3 +3) and PSA was 5.9. I am now 73. Successfully treated and follow up every year for 5 years showed my PSA at between .2-.4. For 15 years up untiil now, no symptoms.

According to MD Anderson, I was cancer free or a cancer survivor after the PT Therapy protocol and low PSA.

I just went for routine blood tests and my MD ordered PSA which came back 235. PET/PMCA and Prostate MRI confirmed mets to bone (non sclerotic) and lymph nodes primarily in Pelvis.

Urologist wants me to start on ADT plus other med, but did not mention combining radiation. Have appt with MO tomorrow.

I reached out to radiation oncologist from MD Anderson who suggested before I start ADT (next appt for that is 8/22/) that I first have a CT Core biopsy by interventional radiologist to confirm the type of cancer in lymph node ;have tumor profiling and germline testing as well.

I have listened to Eugene Kwon MD? who stated that biopsy of a few nodes is insufficient that better rout is Guardian360 test-more robust.

Should I first have a core biopsy or just start ADT therapy or Triplet therapy without waiting for biopsy?

Much thanks

[Tall_Allen]

They suspect that it is some secondary cancer, not prostate cancer. The only way to tell is with a biopsy. They have to see it under a microscope with specialized stains. Guardant 360 is not useful for this. You have to be sure about the type of cancer before beginning any therapy.

[Rcole727 in reply to Tall_Allen]

Thanks for your reply. It was mentioned as belt and suspenders.My radiation oncologist advised probably adenocarcinoma, but wants to make triple sure ergo the biopsy.

The urologist said the mets he reviewed on Pet scan shows all PC.

[Cenerus in reply to Tall_Allen]

His PSA is 235, so most likely not some secondary cancer, it's most likely prostate cancer. Maybe it's a new prostate cancer and not related to the original glaseon 6 cancer.

[Derf4223]

Did you go ~10 years without a PSA test?

[Rcole727]

Probably closer to 5 years. Was advised by hMD Anderson I was cured...no symptoms whatsoever, even now.

[j-o-h-n]

Yep there it is, the "cured" word again....

Good Luck, Good Health and Good Humor.

j-o-h-n

[RJAMSG]

Prayers for you and your treatment! Wow, 3+3 rarely spreads, I wonder if they missed some higher grade 4 that was hiding in the prostate and they just missed it in the biopsy. They have improved biopsies like all other treatments since 2009. Best to you.

[Rcole727 in reply to RJAMSG]

Much thanks.

[Mgtd]

Just curious what is it like mentally going through this process the second time after all those years in remission.

[Rcole727 in reply to Mgtd]

Its demoralizing....after thinking you beat it, was told "your cured" and now the pc is worse than when I was originally diagnosed in 2009.

[Mgtd in reply to Rcole727]

I have a friend who just experienced the same thing after 20 years. He told me he stopped the PSA tests because he was cured. No word yet on what he is going to do for treatment.

Hang in there!

[Rcole727 in reply to Mgtd]

Much thanks....!