Radiation not an option?

[ChickenWrangler]

Howdy all, so I was diagnosed with stage 4 prostate cancer with Mets on bones and in quite a few lymphnodes. Tumors from prostate wrapped around colon some. Went from PSA of 278 (Sept 2024) to PSA 1 (March 2025) after 8 rounds of chemo (docetaxel) with one more scheduled for the end of March. Nubeqa and Eligard are keeping PSA and testosterone low. After talking with the doc yesterday he was saying that although the recent CT Scan shows my bone Mets still ”lighting up” that radiation and/or surgery for the lymphnodes isn’t an option. Is that normal? I kind of assumed we would go after the bone Mets when they still seem active and remove as much cancer as possible. I’m 54 and in good health otherwise, so can’t imagine that is part of the equation. Any advice would be welcome.

[GP24]

It depends how many bone mets and lymph node mets there are. The lesion wrapped around the colon is almost impossible to treat. Radiating the colon has to be avoided.

[Tall_Allen]

Debulking is only beneficial when there are very few metastases.

prostatecancer.news/2018/09...

[earthwindandwater in reply to Tall_Allen]

Total bullshit!

[earthwindandwater in reply to earthwindandwater]

If J-o-h-n would have left his tumor in him 20 years ago, would he be eating his two scoops?

[Tall_Allen in reply to earthwindandwater]

Very eloquent (not).

[earthwindandwater in reply to Tall_Allen]

I would love to know of your disclosures for being on a forum when you have no metastasis. Would you like to share them or is this just a hobby for you?

[CAMPSOUPS]

This is probably way out in left field but is your only cancer experience, knowledge thru life hearing about breast cancer, lung, colon etc. ? Its for me somehow the way your question was worded that made me think that.

With metastasized prostate cancer its treated quite differently.

hope you get the best care and have many, many years of benefit.

[MarkBC]

I was 55 when diagnosed. My PSA continued declining for about 7 months after chemo finished. It leveled off at about 0.17. I believe it was about a year after diagnosis that my scans finally reported that there were no visible tumours. I'm not a medical expert but I would say you should wait a few months and give the chemo and ADT more time. Your tumours may continue to shrink. BTW, I was diagnosed almost 7 years ago. The cancer has stayed suppressed until this past December when two small tumours appeared on my scans. I am currently getting radiation on them.

[Adlon57]

I have osteoarthritis due to pigeon chest/deformed chest from meningitis when I was 10, I was misdiagnosed with prostate cancer in June 2022, they thought I had two benign tumours/schwannomas on my prostrate [Schwannomatosis NF3] I had 20 radiation sessions and decapeptyl SR injections, after a number of PSA's I was told that I would no longer need any more PSAs 🙄 meanwhile the radiation had caused my rib cage structure to be "untreatable" [life threatening] I am now sterile due to decapeptyl SR injections. I have Schwannomatosis since 1970, benign tumours grow on my nerve canals on my arms, legs, hands, and trunk of my body, very rare neurological condition. I am 68. My bladder is unreliable, although that was happening from when the benign tumours formed on my prostate late 2019.

[Wife32]

I’m sorry you’re going through this at such a young age. My husband was diagnosed 7 years ago at age 52, so I understand where you’re coming from.

Regarding your situation, I strongly recommend getting a second opinion. Prostate cancer has many variables and different features for each individual, and there are different options based on your individual disease AND your age/overall health. Many top institutions will do second opinions virtually as well, but make sure you find a doctor that specializes in prostate cancer.

Because my husband was young and overall healthy, the doctors recommended more aggressive treatment options which he tolerated well. So my husband has had many treatments including surgery, salvage radiation, adt, cryoablation, sbrt, nubeqa. He’s been on and off treatment over the years and currently has no evidence of disease for the past 2 years. He is still on nubeqa and lupron with a non detectable psa and negative psma scan and mri. The plan is to start to wean him off meds later this year. Please note that he worked throughout all treatments and managed side effects well with his team’s help and consistent exercise.

Best of luck to you and feel free to message with any specific questions.