[M59][EU] Why the recurrence rate% is so high even with brachytherapy+external beam for prostate cancer?

[FiguringOut]

I can't understand what makes cancer return even when people use brachytherapy and combine it with external beam radiation.

The external beam for the pelvis area should take care of micro-mets, no?

Let's assume person does PSMA/PET scan, maybe even PSMA/PET combined with nano-MRI which is latest discovery in terms of MRI as of 2021.

If that is the case, why are there still cases where cancer returns?

How does it form and what are the exact causes that make it return?

PS:

M59, Gleason4+3, PSA7.8, T2C.

[NPfisherman]

Why does the cancer return?? There is always a chance when PCa is discovered that it could have escaped the capsule and migrated somewhere. The treatment you described has a good chance at a cure, but there are no guarantees. Prostate cancer is a no good sneaky SOB and the fact that is is a cold tumor (hides from immune cells) makes it harder for the immune system to defeat. . The newer scans are making a difference. Why not get one of the newer scans and if oligometastatic (less than 4 tumors) enter the Metacure trial?? -some info on Metacure:

healthunlocked.com/fight-pr...

I saw my MO at Cleveland Clinic recently and he believes there will be "cures" using the Metacure protocol. A protocol that I and several others followed in the last 4 years. One gentleman is almost 3 years out without recurrence, another is almost 2 years out, and I am almost 1 year (Thank God !!). All of us off meds with normal T.

Wishing you the best on your journey...

Don Pescado

[FiguringOut in reply to NPfisherman]

Thank you. What cancer feeds of? What makes it grow bigger?

[NPfisherman in reply to FiguringOut]

So you have not done anything yet....surgery, brachytherapy, etc.... Why are you convinced that it will come back if you do a treatment??

[FiguringOut in reply to NPfisherman]

I'm analysing statistics. It seems that recurrence rates from surgery are way higher than from radiation.

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[NPfisherman in reply to FiguringOut]

Do not get caught up in analysis paralysis... figure out the best 2 options....choose the one that looks best to you and go for it....waiting around another 2 months while analyzing may allow cancer to spread...

[FiguringOut in reply to NPfisherman]

Right now it seems a split between Cyberknife (SBRT) and Brachytherapy+ERBT. SBRT Cyberknife is way more convenient location wise, but Brachy+EBRT seem way more tested long term. What do you think?

[NPfisherman in reply to FiguringOut]

I think you know what you want to do... like Nike says, "Just do it !!". Waiting is pointless and increases the chance of a spread. Scheduling takes time also...You did the research..... It's your choice... Hitting it hard early is best.... Surprised that no one talked about ADT plus abiraterone post treatment as in the Metacure trial.... Whatever you do.....Good luck...

Don Pescado