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Rising psa 15 years after radiation: Is cancer back?
Prostate Cancer | Last Active: Apr 6 2:53pm | Replies (26)Comment receiving replies
The PCRI conference had doctors discussing what to do with reoccurrence. While salvage radiation has been the standard for quite a long time, the doctors there said that only 1/3 of the cases of reoccurrence were result of metastasis in the area where salvage radiation was done.
It was highly encourage that people who have raised PSA get PSMA Pet scans to find out where the metastasis actually are. 2/3 of people will not benefit from salvage radiation they claim. The doctors recommended finding the metastasis and zapping them with SBRT radiation. They feel that in many cases that can cure the patient.
Replies to "The PCRI conference had doctors discussing what to do with reoccurrence. While salvage radiation has been..."
Hi Jeff, building on another of your excellent posts, what benefit will a PSMA give if the smallest area of metastasis it can “see” is 2.7mm?
How can SBRT be done on micrometastases?
And how many men in this forum with rising PSA’s - some as high as double digits - have NO evidence of presence of cancer anywhere in their bodies.
It seems that the “experts” are speaking out of both sides of their mouths: have PSMA’s to spot the 66% of cancer that resides outside the salvage treatment area….oh, and by the way, PSMA can’t really find it anyway….WTF??
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+1 here. I had my spinal metastasis radiated (even before the prostate itself), and one of my oncologists suggested that might be one of the reasons why I've been in remission so long. Of course, that's just their professional hunch, not scientific evidence.
It seems to be best practice now for treating oligometastatic prostate cancer to radiate the metastases as well as the prostate. For polymetastatic, of course, that's not practical, so that's where chemotherapy and/or Pluvicto and/or new emerging treatments like immunotherapy come in.
What all the new approaches have in common is hitting metastatic prostate cancer early and hard, instead of the old-school approach of using one treatment until it fails (e.g. radiation to the prostate), then the next (e.g. ADT), then the next (e.g. an ARSI), then the next (e.g. chemo), etc. We seem to be getting better outcomes from attacking the cancer hard and early, from multiple directions all at once.
Standard disclaimer: layperson writing here