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.
Radiation not an option?: Howdy all, so... - Advanced Prostate...
Radiation not an option?
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.
Debulking is only beneficial when there are very few metastases.
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.
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.
What is your current PSA? Only either the PSMA pet scan (if the cancer is PSMA avid or the FDG pet scan could show that the cancer is metabolically active therefore a real cancer, but bought scans could show false positives. Therefore the best is to wait until the Mets show up also on a nuclear medicine bone scan just to avoid radiating something what is not a cancer.
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.
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.
this is the update we are hoping to get as well. My husband was dx 4 mos ago at age 56 and is an amazing athlete. This was a shocking dx for all of us. Currently on chemo (#4 out of 6 completed yesterday), nubeqa & lupron. Labs are great and PSA has decreased like crazy!!! He cont to exercise and eat extremely clean. Question: what city are is your husband being treated? We had 4 “2nd opinions” and they ALL agreed to the same plan that he currently is on. (we are in Northern VA) We are going our first visit at the Mayo clinic in MN for a further (nxt phase if you will) plan.
We live in Cleveland. We have docs here at Cleveland Clinic and Case Comprehensive Cancer Center (UH) , but our lead doctors are at Mayo Rochester. Over the years we’ve had opinions at MD Anderson, Duke, Johns Hopkins as well. When he was diagnosed 7 years ago, many of the treatments that are now “gold standard”weren’t common, like triplet therapy, psma scans, radio pharmaceuticals, drugs like nubeqa, and more. The input from these excellent institutions helped us learn what was available and appropriate for my husband’s individual situation. They did treatments before many of them because more mainstream, which I feel has contributed to my husband’s positive outcomes.
Feel free to private message me anytime!
Hey bro take that ADT holiday trust me it's worth it, your psa likely won't rise for a few years and if it does rise slightly is normally due to diet changes or low discipline with diet that'll make it rise. I've been on nilutimide since 2010, stopped the eligard s 3yrs ago psa is undetectable non existent whatever they wanna call it, I'm better, my sex drive is trash but I get off on music, I play most instruments masterfully and my significant other iinnerstands me and my biological mess🤣 yeah we bother each other so what, errrrbody got good and bad days, it weeks, heck can be longer, but the one that stays when ya life is a wreck, that my man is a Friendship set on Fire, most others call it love but I know what u be sayin lol. Peace, love n light paahtnuh🫡
So ChickenStrangler, where are you being treated (name? city? state?). Hopefully they specialize in Pca.
Good Luck, Good Health and Good Humor.
j-o-h-n
