A Real Stunner

Bobby Mac,

I heard they charge a lot. I have no idea how good they are, and don't mean to imply any endorsement.

Here are the contact details:

www.exceldiagnostics.com/diagnostic-imaging/pet-ct/

- Allen

Allan,

you write: „If a distant met is detected, curative options are off the table“. I do not really understand what makes the difference between a cancerous lymph node met in the pelvis vs. a cancerous lymph node met at the throat. Both can be destroyed with SBRT.

Georg

Wow. Too much for me to follow all the convolutions of this one.

Let me simply add, my G9 cT3 (by 3TMRI), was treated by IGRT and HT. I had about a 40% chance of undetectable lymph node involvement, so we treated all of them to 50.4 Gy, then concentrated the rest on the prostate to 79.2 Gy. Then HT to hopefully starve out any baddies that were out there systemically.

While I recognize you don't want HT, it is a definite help for high risk cases treated by IGRT. It's no picnic, but what you have to keep in mind is those wretched Type 5 cells are rather easily metastatic. They're so distorted, they don't even remember being prostate cells anymore. So, doing something systemic is a pretty good idea since you can't know if those little dandelion seeds have landed elsewhere in your body. They're what the HT is intended to degrade/destroy over the cells very slow division cycles.

All the best in your decision making. It's complex, not easy, and can be a bit emotional.

Finally, as a fellow G9 5+4, let me welcome you to the G9 Crew. We have thread that's a gathering place for those facing this diagnosis, since it has some unique concerns. Here's a link to it. You'll find I've taken the liberty of placing your forum name on the roster in the least favorite chapter of the least favorite club no one would ever want to join!
www.healingwell.com/community/default.aspx?f=35&m=3182035&g=3182504#m3182504

ST
Like I said spend a dime and arrange a phone consult with Dr Dattoli who treated Snuffy Myers who is in durable remission. You are exactly the type of case which is in Dattoli's wheelhouse.
Bob

TA
Fascinating observation re: PCa in pelvic lymph nodes! I know your views on extraordinarily high doses of IMRT, but it would seem that "carpet bombing" all of those nodes when a couple were found to be "suspicious for PCa" would stand a chance of halting progression.
Bob

George,

What you're talking about is slightly different than what's discussed in that commentary... Here's what I wrote about it:

SBRT boost radiation therapy in intermediate- and high-risk prostate cancer

Whether it's with a brachy boost, an SBRT boost, a proton boost (or even a carbon-ion boost if one lives in Japan or Germany), or SBRT monotherapy, they are all trying to get levels high enough in the prostate itself where cancer concentration is highest. At the same time, they are trying to avoid unnecessary toxicity by putting less radiation into the wider area where the cancer concentration is lower. They all have excellent reported outcomes.

- Allen