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PSMA PET results 6/6/25

Prostate Cancer | Last Active: 5 days ago | Replies (25)

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@jeffmarc

With Positive margins they usually want to do radiation. Nothing else is going to remove it unless you go back and did surgery again, And they don’t do that. So this is a case where they’re probably going to do salvage radiation, I would think, It’s possible they could narrow it to just the areas that have margin spread, I’ve not heard of that being done.

With a Gleason nine aren’t they putting him on ADT? I know it’s not spread, but if the margins aren’t clean, that means that something had spread outside the prostate. You should speak to the doctor and ask them whether ADT and an ARSI (Zytiga or a lutamide) are called for in this situation, considering he is a Gleason nine. You really want to try to suppress it as much as possible so you have a chance of remission. I ran into too cases where people had eights or nines, didn’t have ADT and had metastasis in a short time. I’m mentoring someone with that problem right now.

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Replies to "With Positive margins they usually want to do radiation. Nothing else is going to remove it..."

Thanks @jeffmarc !
I’m 3 weeks out from surgery. 1st RO meeting is June 23, 1st MO meeting is July 16. They told me I have to wait at least 3 months for adjuvant radiation, but I will be asking these doctors about ADT and according to what you and others have written, and from what I have read, I should be on ADT for 2 years. Any other recommendations? By the way, not looking forward to ADT but am being aggressive to fight the PCa that I have. I don’t expect the doctors to push back, but who knows? Do you think they will prescribe Eligard, Lupron or Orgovyx?
Also, do ADT drugs work for Gleason 4+5=9 ? When you say those others got metastasis in a short time, how short? And did they have distant Mets to the bone or local lymph nodes?
Thanks!!