Lymph node dissection

Hi,

I haven't attended the board in a while (classic out of sight, out of mind) and thought I'd share my experience to date with Lymph Node Dissection (LMD) if it could provide any information to anyone.

My PSA rose in recurrence in late 2016 and topped off at 3.14 in July 2017.

I had a gallium scan which revealed two small nodes, 5.5 and 11mm and no other evidence elsewhere of disease.

After considering several directions for treatment I chose LND and Dr. Jeffrey Karnes as my surgeon (who is an excellent physician I must add).

My decision was largely fostered by this article of outcomes of LND. You can see some statistical flat lining in the charts of bio medial recurrence (psa rise) around the 3 year mark post surgery and beyond, translating to around a possible 25 or so percent of remission / cure rate for someone with my parameters as per Dr. Karnes.

http://www.eu-focus.europeanurology.com/article/S2405-4569(16)00009-2/fulltext

27 lymph nodes were removed and I have not really experienced much in the way of negative side effects since after healing. LND is quite invasive and it took while to heal for sure. I did return home from Minnesota only after four days. I think at least week would have been better for me personally as I near passed out in the Atlanta airport from dizziness, digestive problems and exhaustion.

My nadir post initial treatment was .15. My psa bounced between .2 and .4 for years before taking off into recurrence.

After the LND my PSA went down to .08 and is holding there after 7 months. That means those lymph nodes were active all along and though they were radiated along with my prostate and seminal vesicles, they did not receive enough radiation to kill the cancer cells.

So far, so extremely good. Though I understand the cancer is likely to return I am in the best position possible I believe for my situation, buying me some time, if nothing else, that I am not in systemic treatment. Perhaps if and when cancer does recur another treatment choice will be on the table.

I considered LMD one last chance for cure for me, considering current options. Time will tell.

Thanks again to you all for all your past navigational help!

Michael

Hi Allen,

Thank you, as always.
I hope it turns out to have been a wise decision. We'll see.

In the mean time I'm gonna eat lots of black walnuts. It's a family tradition as my father and grandfather both gathered shelled black walnuts as a hobby. Juglone is an agent in black walnuts that has cancer suppressive qualities. Juglone suppresses competing weeds and saplings from germinating and you often see spartan growth around a black walnut tree. In my mind I see free floating cancer cells being suppressed in the same way. Likely ridiculous I can guess, but there is nothing wrong with some stress relieving faith in something abstract. In black walnuts I now trust...

I hope you are well.

Michael

Yarbo3 said...
but there is nothing wrong with some stress relieving faith in something abstract.

I agree! Diet modification is the one thing we can do to regain a semblance of control. I checked my "walnut" file, but they all seem to be about Persian walnuts rather than black walnuts - perhaps the chemicals aren't too different. Unfortunately there's never been a human study, but it works great in mice (as many things do). FWIW, here are the studies I have:

/www.ncbi.nlm.nih.gov/pmc/articles/PMC3709881/
/www.ncbi.nlm.nih.gov/pmc/articles/PMC3513713/
/www.ncbi.nlm.nih.gov/pmc/articles/PMC4259176/