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Anyone have Prostate Cancer Stage 4 with good results?

Prostate Cancer | Last Active: 6 days ago | Replies (58)
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@heavyphil

Hey rick, congratulations! You went thru a lot but came out better for it….one question I have: 5 fractions SBRT is usually associated with some form of CAT/MRI Cyberknife/Meridian treatment to the prostate gland.
But your cancer had spread to the pelvic region and even though the ADT shrunk those tumors to a size undetectable by PSMA, as you correctly point out - it doesn’t mean they are gone.
So why weren’t you given a more inclusive multi visit treatment with radiation that targets BOTH the gland and the pelvic region simultaneously - as in IGRT for salvage radiation?
I’m not an RO and probably displaying my ignorance here but did your doctor explain the ‘why’ to you? Just curious since I’ve met other men who’ve had similar cases and were given 25-39 lower dose treatments. Thanks!

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Replies to "Hey rick, congratulations! You went thru a lot but came out better for it….one question I..."
rick137 | @rick137 | 6 days ago

@heavyphil

Good question. I misspoke there were two tumors detectable in my pelvis if left obturator lymph node is in the pelvis. The following is from the two scans before radiation therapy. I presume resolved means disappeared. My conclusion, if my understanding of the med speak is correct, is that the only tumors worth radiating were in the prostate and one or two very close to the prostate. So the radiation did, in fact, cover all. But perhaps your understanding of anatomy is better than mine. The MRI image I watched during radiation contained two areas. One was contained within the other, at some intervals touching and at other intervals with distinct separation. Since the radiation was three-dimensional the areas were projections but of what I do not know. Perhaps the inner was extent of radiation in one volume and the outer the extent of radiation in another.

2024-09-28 PSMA-Ga68-PET/CT w/IV Contrast
"History of oligometastatic prostate cancer with decreased PSMA uptake within the prostate, with a few remaining foci of intermediate uptake. Previously noted uptake within the seminal vesicles and a majority of the pelvic lymph nodes has resolved, with the exception of a left obturator lymph node and left pelvic sidewall lymph node, which now both exhibit intermediate PSMA. No evidence of new metastatic disease."

2024-11-08 1.5 T MRI OF THE PROSTATE WITH AND WITHOUT CONTRAST
"1. Previously seen PI-RADS 5 lesion in the left posterolateral peripheral zone is no longer seen on this exam, likely due to androgen deprivation therapy. No new suspicious lesions.
2. Similar appearance of left obturator lymph node measuring up to 5 mm compared to prior PET/CT."

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