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Is anyone else oligometastatic with low PSA, post surgery?
I have a decision to make.
Last PSA was 0.145, had a second PSMA PET that shows 2 small bone lesions, scapula and hip. 56 y.o. 19 months post surgery. There are a range of options. One is "whack a mole" where bone mets are radiated and that is all. Ranges increase to 2 years ADT, with both focal and salvage radiation.
Has anyone else been faced with these options? What did you decide?
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According to Doctor Scholz At the latest PCRI conference SBRT is the way to go just zap it.
Yes, your doctor is probably going to do salvage radiation, It is the standard of care once your PSA hits .2. You can wait till that happens. Get those spots zapped and see what happens with your PSA.
ADT would make sense to Reduce the likelihood of a reoccurrence.
Of course you don’t say what your Gleason score is or maybe a decipher score. Something to give an idea of how Aggressive, your cancer is. A lot of the decision-making about your cancer treatment is dependent on that Gleason score.
I'm low risk on almost every metric. Gleason Group 2, T1, the MSK nomogram gives a 2% likelihood of me being recurrent due to risk factors. Genetics is clean. No Decipher though.
There was PNI and cribiform on my biopsy. Clear margins, small contained lesion in a small gland. 3.7 PSA was my max. 2.9 at surgery. It has decreased the last 2 tests.
Thinking of doing whack a mole without ADT and seeing how that goes.
I'm just wondering if there is anyone else out there who has experienced this choice. I know I'm a rare case, and I wonder how others have decided on what they chose.