OPTIMAL TREATMENT?

[wolverine11]

I'm high volume metastatic de novo PSA was over 900. After 4 yrs. of Lupron & zytiga became castrate resistant. 18F-DCFPyl scan shows 5 metastatic sites. Had first chemo Taxotere 3 days ago. TA suggested chemo in combination with Xtandi extends OS. Would it be a good step to add radiation as 3rd step to clean up any residual? For hopefully a very long remission. Thank you

[GP24]

You can get the spots radiated with SBRT. There have been no trials yet which showed an increase in overall survival if you do it. But I can understand if you want the mets removed, one does not want to live with visible mets. It could also help against the cancer.

[wolverine11 in reply to GP24]

Thank you for your response. I see oncologist Nov. 6th will ask if SBRT is something I can have done to increase OS

[GP24 in reply to wolverine11]

Here is an overview of the trials testing SBRT to remove mets: urotoday.com/library-resour...

Not mentioned is the ARTO trial which tests SBRT to remove mets in castration resistant patients with good results so far: urotoday.com/library-resour...

[God_Loves_Me]

Agree with Xtandi then SBRT.

[wolverine11 in reply to God_Loves_Me]

Thanks

[Tall_Allen]

It depends where they are.

[wolverine11 in reply to Tall_Allen]

L3 vertebrae body ,bilateral Iliac bones, right clavicle

[Retireddoc in reply to wolverine11]

Those sites can all be treated with SBRT and that is personally what I would want done.

[wolverine11 in reply to Retireddoc]

Thanks will request from my oncologist

[NanoMRI]

To clean up six lingering/progressing metastatic pelvic lymph nodes, salvage extended pelvic lymph node surgery with frozen section pathology method was my third treatment choice. Coming on seven years and doing very well, no chemo, no ADT. All the best!

[wolverine11 in reply to NanoMRI]

Congrats!

[dadsdrdawn]

Praying for your strength and optimism.

[wolverine11 in reply to dadsdrdawn]

Thank you...This is my fourth day since Chemo. Feel some fatigue, went to the gym anyway.

[Mgtd in reply to wolverine11]

Way to go. Keep up the exercise work!

[wolverine11 in reply to Mgtd]

Thank you for your encouragement. I'm inspired by Dockham

[Maxone73]

You could look into this: urologytimes.com/view/fda-a...

or this: urologytimes.com/view/trial...

[wolverine11]

This SYNC drug looks promising...Thanks Maxone73

[Rocketman1960]

I would not hesitate to use SBRT. Have done so twice to zap the bad guys. Whack a Mole. If nothing else, it lowers the tumor burden on the body.

[wolverine11]

Thanks Rocketman1960. Will ask medical oncologist to refer me to Radiation oncologist

[Rocketman1960 in reply to wolverine11]

It's good to have a RO on the team anyway because we all know there Will be a time when its needed. Good Luck to you! You got this!

[wolverine11 in reply to Rocketman1960]

Appreciate, Thanks