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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
"But if there is a mass (greater than 2.7mm since PSMA can detect it) that you CAN see, it has to mean that there are micrometasteses that you CAN’T."
Yes, there may be — that's why they don't talk much about a "cure" for stage 4 prostate cancer, oligo- or polymetastatic.
I think the idea is that we use ADT + ARSI (say, a -lutamide) to keep those individual cancer cells and "micrometastases" dormant, or at least, to slow their progression down to a crawl, then we zap any big ones that do manage to grow.
One line of thinking is that big tumours might provide critical support to help smaller ones to grow, so zapping the big ones may even help ADT and ARSI to keep the little stuff dormant.
It's definitely a bit like playing whack-a-mole right now, keeping stage 4 under control, but at least we some decent mallets now to whack with.
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You hit thr nail on the head, North. Yes, SBRT for metastases but you MUST be on some form of hormonal therapy as well.
It DOES keep you alive, but all the SE’s still make me gravitate toward salvage radiation if I have a chance of stopping it there.
And I don’t doubt for a second that there may be some kind of communication or signaling between the larger tumors (or the gland itself aka”the mother ship”) and the microscopic ones always lurking.