HealingWell
Search Close Search
☰

Round three begins, SBRT to oligo met

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 3/9/2017 2:19 PM (GMT 0)
First SBRT treatment to common iliac lymph node started yesterday, 3/8/17, and was washed out five hours later. Anyone else experience this after one treatment? Feel better this morning but was surprised by the quick reaction to treatment.
I feel blessed to have Tulane Cancer Center in New Orleans handling my case. They are unbelievably thorough during the planning stage and I expect that to continue during treatment. How about it compiler, are you treating your problem lymph node? I hope so and wish you the best.
Posted 3/9/2017 5:58 PM (GMT 0)
So far so good. We all hope you do well. I am glad to hear the positive report on Tulane. It is likely my choice should the demon show it's ugly head again.
Posted 3/9/2017 7:27 PM (GMT 0)
It depends how many Gy they used. With SBRT you can apply a higher effective dose in one session than with IMRT in 40 sessions. I know of one CyberKnife center that uses 20.2 Gy in one session. This results in a much higher effective dose than if this is split over several sessions.

George
Posted 3/9/2017 8:35 PM (GMT 0)
I'm glad you are feeling better today. Did you have a PET scan to determine the nodes to focus on? If so, what was your PSA when you had the scan. I'm very encouraged by the idea of going after hot spots for oligometastisis but I wonder if this is considered standard of care yet or is it just being done at progressive institutions?

How many treatments will you receive?
Posted 3/9/2017 8:59 PM (GMT 0)
good luck woodpecker43!
Posted 3/9/2017 9:37 PM (GMT 0)
Annie,

going after hot spots in a oligometastatic situation is not standard of care and there is no final proof that it is beneficial. However, I think it is very likely to be beneficial.

However, this should be done after a successful treatment of the cancer in the prostate bed. Since your husband has his prostate only partly removed and cancer has spread to the bladder, treating mets makes no sense in my opinion since the cancer could not be treated completely in the prostate bed.

ADT is the right treatment now.

George
Posted 3/9/2017 10:02 PM (GMT 0)
Annie88-

Spot SBRT treatment of individual lymph nodes is only being done in clinical trials or at the discretion of ROs, definitely not standard of care. The reason is that there is no evidence it accomplishes anything. But if it is in a low-toxicity place and doesn't prevent other treatment -- why not? A much better case could be made for treating the entire pelvic LN field -- if it is in one node, it is definitely in many more. In some cases (near upper bowel, not enough visceral fat), spot treatment may interfere with later treatment of nearby nodes. We don't really know whether whole-pelvic treatment is effective - there are a couple of large randomized clinical trials that will tell us.

Woodpecker-

My guess is that you had a stress-related response. Fatigue from radiation is a cumulative effect when radiation is given for a long time. It wouldn't happen from a single spot treatment. Be sure to keep up with your exercise.
Posted 3/9/2017 11:48 PM (GMT 0)
Annie
Tulane performed an MRI with and without contrast, a full body bone scan, and a CT scan with contrast, all in one day since I live three hours away, prior to treatment. These followed an MRI and PSMA scan at the National Institutes of Health in Bethesda, MD last September that identified the problem lymph node.
Best wishes
Woody
Posted 3/9/2017 11:54 PM (GMT 0)
Annie
I did not answer all your questions, sorry......PSA is 3.5, I will receive four treatments.
Best regards
Woody
✚ New Topic ✚ Reply