Update on Bill-Refractory HT advice needed please

Dana,

I can see why the tumor board doesn't think the pelvic lesion is related to PC because it is unusual to grow while PSA remains undetectable. But I can also see why his RO thinks it is a PC tumor because it responds to radiation. I guess that a biopsy could resolve the question, but as long as the radiation is working, it may be academic and not really important to do so.

As long as his PSA is undetectable, there's no reason to suppose that his cancer has become castrate-resistant. Even when that does occur, hormone therapy is not stopped -- other kinds of hormone therapy are added on top of it.

I think some of the signature may have been cut off. Did he have adjuvant radiation after the RP failure, and were his pelvic LNs treated?

It sounds like he has a team of very concerned doctors at Cleveland Clinic who are staying on top of things.

- Allen

Thanks so much Tall Allen and LupronJim! I really appreciate your replies. He did have radiation right after his prostatectomy because it was outside the margins. That was about 4 years ago. A couple years later, his numbers rose again, so they started him on hormone therapy. His numbers have stayed undetectable since, but now this tumor on the pelvis happened. They did a biopsy but it was inconclusive, which was why the doctor had the tumor board look at it. They agreed it wasn't prostate cancer, but now the radiation guy disagrees. My thinking was that if it is prostate cancer returning while he's still on HT, it's refractory and usually they stop or change the medicines at that point. Wrong?

Many thanks,

Dana