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Anyone had the same? PC - Micrometastatic recurrence | PSMA PET neg
Prostate Cancer | Last Active: 17 hours ago | Replies (7)Comment receiving replies
@jeffmarc
Thank you, Jeff - much appreciated and thanks for sharing some of your story. Yes, my Dr has requested a new germline test to see what the biology of my PC is. We don't know the doubling rate yet, as my PSA just began elevating about a month ago (after 1.5 years of undetectable).
We did radiation to the prostate fossa after detecting SV invasion after RP. I am constantly wondering if we should have done RT to the whole pelvis with salvage RT and IF that would have benefitted me...but its too late now. I'm going to see what the Drs at MSK say about RT to entire pelvis/lymph nodes or if the SBRT. I believe IMRT can still be done (outside of the P fossa that was previously radiated).
The problem is, its now micrometastatic and not showing up on PET...so it could be anywhere. RO strongly believes it is small nodal.
I want the most aggressive treatment plan now to give me the best shot of long-term remission.
Replies to "@jeffmarc Thank you, Jeff - much appreciated and thanks for sharing some of your story. Yes,..."
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@darrenh05 Hey Darren, I used Dr Andrew Barsky at Sloan in Commack. He’s young and damned smart too.
The RO’s in NYC are no slouches either so you are in good hands.
I just had SRT and the new protocol is prostate bed PLUS pelvic lymph nodes since 30% of all recurrence comes from the nodes.
Not entirely sure if they can target the nodes only, without hitting the bed a second time; maybe (MAYBE!) with proton but probably not with photon.
I would want exactly what you want: aggressive treatment now…but it is tricky at this point. Number one, You really don’t know where the cancer is; secondly, ADT will probably stop proliferation and suppress your PSA but for how long?
Or, you can wait (which is agonizing as we all know) for the cancer to grow until it becomes visible on PSMA and then hit it with SBRT as Jeff suggested…but what about possible micrometastases that PSMA can’t detect??
Yes, I have more questions than answers and I totally empathize with your situation. My suggestion, FWIW, is to get at least two opinions. All RO’s are different in their approach, the way they think and their treatments.
My first RO at Sloan was an older, set in his ways kind of guy who was going at his comfort level of treatment no matter what…success or failure didn’t seem to matter cause this is the way I do it dammit!
But thank goodness he left Sloan before my treatment began and I was assigned to Dr Barsky. Less treatments, different ADT, and a whole lot nicer human being; and being young he is really up on the latest research and in fact, has co-authored various studies as well. I would certainly consult with him if you need a second opinion. Same hospital, but different person…Best,
Phil