Radiation therapy

The first question is how many metastasis do you have?. If five or less, they should be zapping them. If more than five, then they usually want to do chemo or Pluvicto.

There is no reason you should wait for this. If you have metastasis to the bone, they can get worse, Even on ADT.

If your PSA has become undetectable, it can stop the metastasis from growing and spreading, But you still want to get them zapped With SBRT radiation if it is possible. Some metastasis are in areas that can cause problems if they zap them.

You have to be proactive for your treatment. Many doctors will just let things go or not let you do certain things unless you really press them, that you want that done. If you can’t get your doctor, you have now to do something then you do need to go to another center of excellence, At least for a second opinion.

@jeffmarc Thank you Jeff, I have another injection mid November and an Oncologist appointment following that and I will ask directly until he answers me, but I feel that I should get a second opinion anyway, Monday I will call Mayo Clinic they are a Center of Excellence correct?

Thanks
Mário

@zzotte
Yes, Mayo is a really good place to go, Definitely a center of excellence.

@jeffmarc Thank you Jeff calling them tomorrow

@zzotte I agree with Jeff. Definitely get a second opinion and Mayo is a great choice. Then come back here to talk about the different radiation machines that are out there to choose from as they are not all the same in their effectiveness.

Mario, It doesn’t seem that you have even spoken to an RO from your post - just a medical oncologist giving you ADT… Is that accurate?
Phil

Recent video by SBRT pioneer Dr Michael Steinberg UCLA suggests up to 12 metastatic lesions can now be zapped using SBRT. Check out Steinberg video lecture on this subject at Dr Mark Scholz PCRI website for details.

I know the former CEO of the company that introduced the first SBRT machine and he worked closely with Dr Steinberg to perfect it and get FDA approval to offer it publicly. I now Steinberg is a thought leader in the treatment of treatment of PC lesions that have escaped the prostate capsule

@capatov thank you I will check it out

@heavyphil Yes, every time I ask my oncologist about the appointment with the radiologist he says this and that and the other, earlier at the beginning of my treatment he was not too keen on radiation because even though the PC has spread it’s so small that 3 years ago “ we would not had detected” he said ADT would take care of, I insisted on radiation and he then agreed that would be beneficial, on another visit my oncologist said that the radiologist was only going to the treat the prostate but not even that has come to fruition, so I’m kind of ready to move on

@zzotte oh man, I DO NOT care for this MO at all! And that is not a medical opinion, but the opinion of someone who would have moved on months ago!
Not your fault- you see PSA dropping and you’re thrilled - I totally get that. But an RO could offer scans and treatment to areas really in need of it now…
Glad you are moving on…the sooner the better. Good Luck,
Phil