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Recurrence in pelvic lymph node
Prostate Cancer | Last Active: 15 hours ago | Replies (26)Comment receiving replies
OK, I see that the study was either treatment specifically to the metastasis in the nodes with 3 sessions of SBRT - the therapy that Dr Scholtz claims is better than full salvage therapy…OR…25 sessions of IMRT to the pelvic region and nodes, which is the treatment I just completed at Sloan…
My question was: how can you have even more radiation since you’ve already HAD salvage therapy?; but I think it’s because you only got it to the prostate BED initially and now the radiation will be directed to the pelvic lymph NODES and surrounding area…I think!!
Again, I would do this more comprehensive treatment (25 sessions with ADT) than whack a mole with SBRT. It just makes more sense to me although others may disagree.
Phil
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@heavyphil
Hi Guys, I am the wife of Joe, who has biochemical recurrence after 7 years of initial treatment: RP and prostate bed radiation: 7 weeks I think.
OK, so now PSA is detectable at 0.149 (no ADT after initial treatment.
My question: must make a choice here:
1)Kaiser, our provider, wants to radiate the pelvic bed, whether or not PSMA PET, shows any positivity.
2) But, Dr. Scholz, our second opinion go-to: says that's crazy, just do spot radiation as the PSA rises, and you'll be fine -- actually go for a cure. Radiation is the only way to try for a cure in either case.
My concern: salvage radiation is most affective when started at very low PSA: 0.2 TO 0,5 at the very highest and that's a stretch. I think I've read every study by now. BUT PSMA PET most likely will be negative at these early levels. Urologists are unanimous that you start salvage radiation anyway. Most likely PSMAPET is not able to pick up micrometastasis.
So, here's my dilemma, which road does Joe take? I'm inclined to go for broke and radiate the pelvic bed (it's been 7 yrs since the prostate), if we keep waiting around to hopefully find all the lesions and radiate them, we could be missing lots of microscopic metastasis.