Pylarify and ADT question

[DRKC81]

Hello All , My father (74) was recently diagnosed with prostate cancer intermediate (on the border of favorable and unfavorable)

with gleason 7, his bone scan and PET scan came out clean. After much fight I was able to get Pylarify approved. For members who have gotten the PSMA PET can you let me know what the procedure is? Do you take a contrast one day before and on the day of exam followed by the Pylarify injection or is it just the injection?

The RO at MSKCC wants to go with 4 months of ADT and 26 sessions of IMRT. He wants us to explore proton therapy as well since my dad had ulcerative colitis in 1990 which is completely under remission.

Can someone throw light on SBRT vs IMRT vs Proton Therapy and Lupron Vs Firmagon vs Orgovyx.

Thank you all.

[BeTheSmile]

My Pylarify scan required no prep except a small shot just before, and wait one hour. Lie on a gurney with a tube, no noise, not scary. Results the next day. Scan showed no cancer spread! I am scheduled for 6 months of Lupron, with 28 proton therapy sessions.

[mijona in reply to BeTheSmile]

Hi BeTheSmile, I went thru the same thing. Had the PetScan PSMA with Pylarify and just got the injection 1 hour before, sat in a comfortable chair for 1 hour and then the PetScan. My urologist also suggests 6 mo. Hormone Therapy. I am at the point now to decide whether LowDoseRadiation or HighDoseRadiation . And whether the fiducial markers and spacerOar are really necessary with all the new technology. What made you decide one way or the other ?

[1Ubspaine]

I had a similar diagnosis and choose 5 IMRT treatments with 6 months of ADT recommended by my RO. She suggested Lupron, my insurance company forced Firmagon on me. Only difference was Firmagon shots are monthly, Lupron quarterly.I am pleased with results.

One thing I learned that might help someone is the “old school” 40 radiation treatment schedule is outdated. My RO plainly stated the only reason it is still used is because the provider makes more $. Sad.

[Vynbal]

Being borderline fav/unfav consider genomic test such as Decipher to act as tiebreaker. A low risk score might safely spare your father the side effects of ADT.I was on 6 months of Orgovyx and posted my experiences here on a separate thread. I also had PBT, and while I was not eligible, I asked and was told that SBRT style fractionation is available with PBT. Message me if you want more of my experiences.

[j-o-h-n]

Do you know how to do a search here in H.U.? There are a few posts with the word "Pylarify" which I found doing a search, which may answer your question.

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 02/05/2022 10:46 PM EST

[BeTheSmile]

Hello DRKC81, High or low dose radiation is the question. First, radiation would be and was my choice over surgery, too. Second, there is much analysis on this site as to whether high or low dose radiation produces fewer side effects. My choice was low dose for 28 treatments, proton. My fear/impression is that the high dose faster treatments may sometimes produce more side effects,and I was terrified of that. My treatment seems not to have produced any negative side-effects! Good luck, and I hope you get good advice in making your choices.