Prostate cancer in nearby lymph node

Hi Buttrfli,
Welcome to MCC. So sorry your father's PSA is rising. Replies from the community will be more focused if you can provide whatever other background you can such as when he was originally diagnosed, his original PSA, Gleason score, biopsy findings, as well as what his previous treatments were. We look forward to your future posts on your father's progress. Best wishes to you both.

buttrfli,
the lymph node makes me suspect that radiation might be a good choice. Sometimes prostate tumors can become castration resistant. What other testing besides the PSA have been done or are scheduled since the rise in PSA. Is the tumor itself enlarged. Have they ascertained that the node is cancer and not an unrelated infection?
Radiation is usually easily tolerated and painless. Newer equipment is offering a more accurate five session radiation treatment.
I'm glad you are there for your dad.

From what you describe, it may be that he is castrate resistant.

If so, part of the answer may lie in his overall health, any co-morbidities and "life expectancy."

The likely treatment recommendation his radiologist is discussing is MDT - https://pmc.ncbi.nlm.nih.gov/articles/PMC10990025/

A question to ask his medical team may be whether or not to add an ARI - "Another RCT showed promising results of MDT as treatment-escalation method combined with androgen receptor signaling inhibitors (ARSI) in first-line treatment for castration-resistant omPCa."

As others have said, more of his clinical history can help members of this forum respond with their thoughts.

Kevin
Kevin

Diagnosed in 2012. His highest score was 21 i think, i don't recall what Gleason or biopsy said. Urologist got him on hormone therapy and been at 0's for all those years until now. He just had a PSMR scan done. It shows extra activity in the lymphnode right next to it, but no inflammation at this time. And obviously his prostate showing that extra activity as well.

One factor is how fast the PSA has been rising, They call it the doubling time. If it’s very slow then maybe you can wait, or Just get him on something like Nubeqa (Darolutamide) w OK hich has very few side effects, but is real effective when Lupron stops working.

The big factor is how healthy is he at 81. I know some people that are very healthy in their 80’s. They go to the gym or exercise pretty regularly . Has he been active?

Radiation is not necessarily difficult. Some people get fatigue or a few other minor problems, it usually isn’t difficult. When I had it for seven weeks I went to work immediately after the morning radiation, it never slowed me down. You could ask the doctor if it would make any sense to put in a SpaceOAR To protect the bowel, that may not be necessary all the time.