Read the paper linked below for the full scoop… but it seems very positive indeed for a certain subset
Praful Ravi at Dana Farber asks…
Can oligometastatic prostate cancer be cured with ‘total therapy’? Check out our paper reporting on outcomes after fixed-duration ADT +/- ARPI, met-directed therapy and local therapy (if de novo) for omHSPC
At a median of 3yrs after completing a median of 2yrs of systemic therapy, 45% of patients remained progression free and off therapy. Median time to resume therapy was 4yrs. Hint at potential durable long-term remission (and possible cure) with this approach.
Supports ongoing deintensification trials in selected mHSPC patients who achieve an excellent response to therapy, and future trials need to explore fixed-duration therapy in this space. @AtishChoudhury @DanaFarber_GU @DanaFarberNews
Thank you for sharing. This is my exact situation. Recently diagnosed as T3bN2M1b oligometastatic. When we first learned of the 2 bone mets, we were devastated and thought there was no hope. Then met with both Dr. Mark Scholz and my oncologist who both used the word "curative." We said we thought that wasn't an option, but they both explained that, especially at my young age, an aggressive triplet approach (ADT, brachy therapy, SBRT, then docetaxel) there is an "excellent chance at a cure" even though it is late stage. So I am clinging to this sliver of hope for a possible cure at best, and long-term remission at worst.
My treatment included three PSMA PET scans, two surgeries and ADT. First surgery in 2017 to remove the prostate and anything visibly affected. Then a second surgery two years later to remove lymph nodes spotted in a second PSMA scan. A rising PSA in late 2020 lead to starting ‘doublet’ therapy…new at the time…of Lupron and abiraterone. The third PSMA scan was in January of this year that showed that the bone met in my hip socket was gone and there was no evidence of cancer. For now I appear to be cancer free and am off all meds! Checkups every four months. I feel that PSMA PET scans saved my life and were so important in my treatment decisions. Early in my treatment they were not covered by insurance but it was thousands of dollars well spent.
in my case it was well worth it! My first two I did have to pay quite a bit as it was not covered by insurance at the time. But the providers, UCLA and UCSF, gave me a very nice discount. I think it was about $3000 each. Are you sure that your insurance will not cover it?
It can. mHSPC (hormone sensitive) is the same as mCSPC (castration sensitive) . These terms are used interchangeably in the medical literature and clinical practice to describe prostate cancer that has spread beyond the prostate (metastasized) but still responds to hormone therapy that lowers testosterone levels.
The one that differs is mCRPC which means metastatic castration-resistant prostate cancer, where the cancer progresses despite low testosterone levels.
Thank you. It seems that ongoing treatments (eg. drug holiday or not) for the two, mCSPC and mHSPC, when the meds are the same (e.g. ADT + Abiraterone), are identified as being different.
Thank you for sharing this. I thought it was interesting they looked at radiation and doublet therapy (ADT + either ARPI or docetaxel) but not radiation and triplet therapy (ADT + ARPI + docetaxel).
I was oligometastatic and had triplet therapy using darolutamide then finished everything off with radiation to the prostate/pelvic lymph nodes/bone met. Studies like this give me some hope that my outcome will be positive.
C'est très intéressant d'entendre ça. Je commence à me sentir beaucoup plus positive à propos de mon propre état et de ma prochaine radiothérapie pour irradier ma prostate. J'ai toujours des métastases ganglionnaires, mais c'est un meilleur début que ce que j'imaginais.
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Olaparib May Be Effective Without Hormone Therapy in Some Men With Biochemically Recurrent Prostate Cancer
18F-sodium fluoride PET-CT appeared to be a more accurate identifier of bone metastases in patients with prostate cancer. 
