Prostrate cancer in lungs that are subcentimeter in size?

Welcome, @jester2022.
Prostate cancer that has spread to the lungs is called metastatic prostate cancer. I've moved your message to the Prostate Cancer Support Group here https://connect.mayoclinic.org/group/prostate-cancer/

I did this so that you can connect easily with other men who have metastatic prostate cancer in the lungs like @aldenrobert @proftom2 and others.

Jester, did you have a lung biopsy to determine if the lung nodules are cancerous or not? What treatments have you had for prostate cancer?

The lung nodules are so small and flat that they don't think they could biopsy them. The doctor said the PSA has to come from somewhere and the only place that keeps showing up is the lungs from the PSMA PET scan.

I had HIFU in Toronto, Canada in August 2009.

My situation is different. I had my prostate surgically removed (RRP) in March of 2021. My PSA post surgery 0.37 and continued to go up. PSMA/PET did not show anything. 34 rounds of salvage radiation followed. PSA nearly doubled during radiation treatment. Post radiation PET/CT scan did not show any metastasis, PSA continued to go up. 3 months after salvage radiation PET/CT scan showed a metastatic nodule in right in my right lung Hilum and a CT of the chest showed numerous "micro nodules" in both lungs (2mm to 4mm). Biopsy of Hilum confirmed metastatic prostate cancer. PSA had risen to 13.46 as I entered a clinical drug trial. I was put on Orgovyx along with Erleada. PSA dropped to 0.15 in 4 weeks. I had 5 rounds of radiation to the Hilum about 3 months into the trial. My next PET/CT scan was clear and the chest CT scan showed that some of the micro nodules in my lungs had reduced in size or disappeared. When I asked the nurse practitioner if that meant the micro nodules in my lungs were in fact early prostate cancer she said that would be a logical conclusion. But when I asked that question to two of my oncologists I got very different answers. One told me that my question was irrelevant because the micro nodules were too small to be biopsied and therefore no conclusions could be drawn. The oncologist overseeing the drug trial stated "all KNOWN cancer has disappeared" but that there were still micro nodules that had not. I have 2 weeks left in the trial and will be having PET/CT scan, CT of chest and bone scans next week. I can let you know how that goes. Metastatic Prostate cancer to the lungs is not common but is very serious with poor outcomes. If you have the financial means, get a second opinion from a major cancer treatment center in the States. See if there are any clinical trials available. I hope this has been of some help. Wishing you all the best.

Thank you so much for your reply and yes keep me informed. I think you are in great care because of you decisions you made.

Hi,
My husband has recurrent prostate cancer and is on Orgovyx and Zytiga for three months. It PET scan in February showed illiac involvement, and after therapy was repeated in July. The PET scan showed no activity in the illiac area, however, there were nodules in the lung. RUL 1.6 cm and RLL as well. His PSA is undetectable. He had a bronchoscopy to r/o cancer or possible infection. The result was an infection. Best of luck to you!!

I hope you had success in the trial. I have Gleason 8 with lung only metastasis. Ive been on Lupron and Darolutimide for a year but now deciding to take a holiday since I had a good initial response to ADT and PSA is undetectable. I’m trying to determine whether the intermittent therapy is a mistake and if someone with a similar diagnosis has thoughts on treatment.

My Stage 4 Prostate Cancer spread to liver and lungs. Diagnosis in 12/2020, Radiation, Chemo, (2021) + Hormone continues. 3.4 years in overall health is good, maybe best ever. Go for CT Scan next month.

Great to see that you're doing well in 2024 after a liver-metastasis diagnosis in 2020! The prognosis for many cancer situations is so much better than it was 5–10 years ago.

Welcome, @jmarshall29. You might be interested in these related discussion about intermittent ADT.
- Anyone take a Treatment Holiday? Intermittent use of ADT (hormone Tx)
https://connect.mayoclinic.org/discussion/anyone-take-a-treatment-holiday-intermittent-use-of-adt-like-orgovy/
- When to resume intermittent hormone therapy?
https://connect.mayoclinic.org/discussion/when-to-resume-intermittent-hormone-therapy/