Any proof that removing a tumor off prostate bed by radiation or surgery is better than just systemic therapy ?

[Shorehousejam]

Here is my history

PSA rising now 0.77

Going for pet scan tomorrow

Tumour on prostate bed had Radical Prostatectomy with Lymph node removal

03/2023

Stage 4 Oligo Metastatic Prostate Cancer

Original PSA 942.40 at diagnosis 06/2022

Gleason 8 / 9 ductal without large cribform gland,

cT3b CN0 cM1b

Gleason 8 and 9 *4+5=9

Stage 4

Grade 5 :

ypT3a YPT3a

3 lytic lesions resolved to 1 mild avid lesion

Biopsy 15 samples

4 adenocarcinoma

11 benign

Low volume

High grade

Triplicate Therapy

Firmagon @28 days,

Zytiga with Prednisone Daily,

Metformin 500mg Daily

Docetaxel Chemotherapy @ 6 sessions

Skyrizi monthly injection for severe plague psoriasis

VIT D2 @6 weeks, once a weeks, 50k units, Temporary

Thank you

[mperloe]

I'm not sure I understand what you are asking.

[cesanon]

Good question

[6357axbz]

It’s called debulking. There are trials that show advantage. No longer remember which ones

[Tall_Allen]

In what situation? Metastatic (N1? M1a,b, or c?), met volume? recurrent? mHSPC or mCRPC? post-which therapies?

[Shorehousejam in reply to Tall_Allen]

Here is my history

PSA rising now 0.77

Going for pet scan tomorrow

Tumour on prostate bed presently reoccurrence

had Radical Prostatectomy with Lymph node removal

03/2023

Stage 4 Oligo Metastatic Prostate Cancer

Original PSA 942.40 at diagnosis 06/2022

Gleason 8 / 9 ductal without large cribform gland,

cT3b CN0 cM1b

Gleason 8 and 9 *4+5=9

Stage 4

Grade 5 :

ypT3a YPT3a

3 lytic lesions resolved to 1 mild avid lesion

Biopsy 15 samples

4 adenocarcinoma

11 benign

Low volume

High grade

Triplicate Therapy

Firmagon @28 days,

Zytiga with Prednisone Daily,

Metformin 500mg Daily

Docetaxel Chemotherapy @ 6 sessions

Skyrizi monthly injection for severe plague psoriasis

VIT D2 @6 weeks, once a weeks, 50k units, Temporary

Thank you

[Tall_Allen in reply to Shorehousejam]

Since your prostate has already been removed, and you have bone metastases, I don't think there is any further benefit in going after the prostate bed. I think most of the progression at this point is met-to-met and most of your metastases are too small to show up on any kind of scan. You can zap the lesion in your prostate bed and your visible metastases if safe. But the most important thing is intensive systemic therapy. Zytiga is still working for you, but switching to Xtandi+Pluvicto is reasonable too, if your PSMA scan shows avidity.

prostatecancer.news/2024/04...

[NanoMRI]

Well, I had six cancerous pelvic nodes, including para-aortic, surgically removed six years ago. So far, no need for ADT/chemo or other. All the best!

[God_Loves_Me in reply to NanoMRI]

Thank you Next goal is find good doctors. Anyone here has good doctor recommendations please share

[Shorehousejam]

updated post

[GP24]

Prof. Fizazi discusses here that the prognosis is better when the prostate is treated. No matter how advanced the tumor is.

urotoday.com/video-lectures...

[EdBar]

Only anecdotal here, but around 9 years ago I had my prostate and several nodes radiated despite being dx stage 4 with extensive bone mets too. I felt that debulking the main tumor load would be a good move, my radiologist said it could make systemic treatment more effective. When I later became a patient of Snuffy Myers back in 2015 he said it was one of the best things that I could have done, “eliminating the mothership “.

Ed

[dhccpa in reply to EdBar]

Interesting. I've heard so many conflicting things on doing that if already metastatic.

[God_Loves_Me in reply to dhccpa]

Agree, recurrence is known risk. To me it is also one more treatment options. It does not mean patients will avoid chemo and other treatment.

[EdBar in reply to dhccpa]

Well eliminating the original source of the tumors and reducing tumor burden made sense to me.

[dhccpa in reply to EdBar]

Me, too.

[j-o-h-n]

Current Psa number is ?

Good Luck, Good Health and Good Humor.

j-o-h-n

[Shorehousejam in reply to j-o-h-n]

0.77 PSA

I think I put all in original post

[j-o-h-n]

Thanks, Oh, the one you posted a year ago?..........

Good Luck, Good Health and Good Humor.

j-o-h-n