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Prostate cancer of the right common iliac medial artery lymph nodes

Prostate Cancer | Last Active: Apr 19, 2023 | Replies (5)
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@rad62

Hi, I have also a recurrence in the right common illiac lymph node after RP in 2019.
My doctor says this is oligometastasis, beyond local recurrence but not distant mets.
How are they proposing to treat you? They are suggesting to me I might benefit from surgery, removal of the lymph nodes and this may delay the start of radiotherapy and hormone treatment, although I'm not convinced this is the best option.
I would appreciate hearing what your team are suggesting for you.
Best regards

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Replies to "Hi, I have also a recurrence in the right common illiac lymph node after RP in..."
bandsaw | @bandsaw | Apr 18, 2023

Thanks for replying,
I was diagnosed with stage 3 prostate cancer back in late 2017. PSA 30 and Gleason scores of 7s, 8s and one 9. My treatment was hormone, RT, and high dose Brachytherapy.

The reoccurrance was detected 2 months ago via PSA. My doubling time was 1.6 months. 7 months ago nothing then bang here I am. They did a PSMA/Pet and found two of the Iliac common artery nodes had an SUV of 80 and 88.

So my urologist started me on hormone treatment 2 weeks ago, and I am scheduled scheduled with my radiation oncologist to go in for my RT simulation Thursday.

Only thing that might get in the way of the RT treatment is what was the amount and exact location the the previous RT I received. He was waiting the the data to be sent to him from my previous oncologist. Hopefully I didn't get to many rads before.

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kujhawk1978 | @kujhawk1978 | Apr 19, 2023

I would be cautious of the surgery recommendation. My medical team, urologist, oncologist and radiologist have not recommended it either time I've had reoccurrence in the PLNs based on imaging.

The first time my radiologist treated the entire PLN system, 25 IMRT, 45 Gya. The 2nd time she is using SBRT, five treatments.

With the first reoccurrence we added taxotere and ADT, Lupron. This time we're adding Orgovyx and Zytiga to deal with micro metastatic disease, too small to be seen by imaging.

Here's a link to an article about PLN radiation treatment - https://www.prostatecancer.news/2021/05/new-guidelines-for-salvage-radiation.html

Kevin

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