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Thoughts on treatment options?

Prostate Cancer | Last Active: 3 hours ago | Replies (113)

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Profile picture for Jeff Marchi @jeffmarc

@toomany

It might be possible to use proton radiation to radiate those spots that are in the prostate area.

Here are some other options

Recurrence after radiation - focal therapy or surgery

People who have radiation as their primary treatment have been told by doctors that surgery isn’t really an option if there’s a reoccurrence. Other options are not really mentioned..

This study shows that both salvage focal therapy (HIFU and cryotherapy) and salvage surgery were equally effective at extending the life of a patient that started off with radiation.

Those that had focal therapy had fewer perioperative complications.
https://jamanetwork.com/journals/jamaoncology/article-abstract/2844900

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Replies to "@toomany It might be possible to use proton radiation to radiate those spots that are in..."

@jeffmarc Thanks again for your various comments here, Jeff. They are greatly appreciated. I am looking forward to a tele-health visit this next week with my original (2018) radiation oncologist, to secure his thoughts on things, and to get his 'very' experienced opinion on suitable treatment options for me, going forward. He alone is my "gold standard" when it comes to such things. However, as I have indicated elsewhere, while awaiting this future visit, I met with a 'local' radiation oncologist just recently, who shared the following professional opinions:

1) That any further radiation treatment(s) would be a 'no-go' for me, due to scar tissue, likely to have been caused by my earlier radiation treatments (brachytherapy and beam radiation).

2) That salvage surgery would also be a 'no-go', for the same reason as above (scar tissue), although in fairness, he pointed to several remote, yet notable prostatectomy surgeons who occasionally do perform such (post-radiation) surgeries.

3) That multiple forms of ADT (Orgovyx along with Abiraterone), were essentially the only practical treatments that were going to be available to me 'locally'.

He did not mention HIFU, Cryo or any other ablation, or so-called 'focal' types of treatment, and further indicated that any radio-immuno types of treatments (e.g., Pluvicto, etc.), would be contraindicated, since my cancer is not metastatic. Needless to say, his views left me both disappointed and a bit bewildered, but I strongly suspect that what you and others have shared with me here in the way of other options, along with whatever my former (2018) oncologist is likely to say next week, will markedly differ from this gentleman's views.

Anyway, thank you again for sharing!