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Scheduled for a Radical Prostatectomy and having Second Thoughts

Prostate Cancer | Last Active: 18 hours ago | Replies (44)
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@wandyfisher

Thanks. That’s one of the questions I have for my RO as I know there is a possibility of microscopic lymph involvement even though none was seen in PSMA PET. The MSKCC nomogram for me shows 14% chance for lymph node involvement. I thought I read somewhere that SBRT lymph node radiation was possible. Maybe it’s just not part of the standard protocol. I’m really trying to avoid a 20-40 session IMRT. Lots of considerations and consultations still ahead of me before I finalize my choice. How much did nomogram predictions factor into your decision making process?

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Replies to "Thanks. That’s one of the questions I have for my RO as I know there is..."
heavyphil | @heavyphil | 1 day ago

Honestly, I did not consult any normograms; I had read quite a few articles that primary radiation as well as salvage radiation (which I had) failed a certain percentage of the time due to micro-metastases to the pelvic lymph nodes.
So when I consulted with MSKCC I was told I would have 25 sessions in total with 6000(?) delivered to the prostate bed and 4500(?) to the pelvic lymph nodes.
I understand your desire to have 5 sessions, but if you are worried about pelvic spread go for the 25 and sleep soundly…JMHO

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