ORIOLE ain't just a tweety bird

Some may remember my story - 2012 PSA=11.1, G7 in 12/12 cores. RARP Dec 27, 2012, ADT chemo started 2 weeks later, 40 radiation treatments 3 months after that. Total duration of 1st round ADT chemo for 2 & 1/2 years. A whiles after end and recovery from ADT chemo PSA started to climb. When it hit 3.3 in Nov 2019, back to Eligard. Aug 2019 axumin PET scan showed 3 hot pelvic lymph nodes so Jan 2020 added Xtandi. PSA dropped to < 0.02 (still there).

MO moved away to another practice a few hours drive away as did my previous RO. Got a new RO last summer who sympathized with me, but didn't do anything as he retired soon after I met him. He was old school and was not familiar with more current research. Met my new MO soon after that and he drop-kicked me to an RO associate who specializes in prostate cancer. He is up on current research, went through my file and scans then told me:

"3 soft tissue mets near each other and not far from the original site fits the definition of "oligometastatic" disease. The 3 mets are above the original radiated area. We can hit those mets (spot treatment) and irradiate the other lymph nodes nearby without hitting any critical structures and without hitting the previously irradiated areas."

He has done this for other guys with great success and says he figures I have a "98% probability" of a cure. I will need to stay on the Eligard + Xtandi combo for another year during and after treatment. Expected SE's will be fatigue and diarrhea.

I am going to give this a shot, go in for the butt cast and dye resist scan this Dec 17, will get 25 - 28 consecutive weekdays of radiation treatments. Will have to chug the barium and get an I.V. for the dye while I am on the table for the scan so he can more accurately map out the affected nodes. He says I won't need another Axumin PET scan for this.

All treatments will end Jan 1, 2022, then we will just watch the PSA. I am enthused despite a very small risk of collateral damage. I suspect the radiation side effects will not be much fun. I will follow this up here after my treatment is over.

Here is a link to an update on the ORIOLE study:

http://www.bu.edu/shipley/2020/08/18/oriole-trial-update/

What great news and congratulations on your diligence in finding a top grade doctor. I am always all for multiple assessments with all major situations. You were forced into yours by the moves and retirements of doctors, but you knew to stay diligent and find the best.

Your RO sounds both competent and confident. That is the best combination. Best wishes and I expect you will have wonderful results. You are on a well marked trail on this one.

Great News TrailGuy
I'm glad you found a Dr with a plan and a probable solution for your situation
Best of luck with the new treatment

Congrats, Trailguy.

I was also part of the ORIOLE trial (out of Johns Hopkins). As you can see if you click on my story below, my PSA dropped to 0.2 and has stayed there for the post two years. I'm currently taking no meds for prostate cancer.

...Jerry

PS: I had radiation for my primary treatment which resulted in biochemical failure in 2011.

Hello, Trailguy ---

Sounds like you have a multi-tiered treatment plan that is proactive.

Step by step, you will knock those radiation treatments out this winter, and they will be in your rearview mirror, before next spring.

You have a clear-cut plan in place, with a medical team sharing their guidance.

It sounds like you have a clear understanding of what the treatments entail, and I can tell you are ready to get started.

Get those boxing gloves on, step into that boxing ring that awaits --- and go for the knock-out punch!

We'll be here --- supporting you --- cheering you through those daily treatments.

Here's to the fight -- and to your FIGHTING SPIRIT!
C-Y-C-L-O-N-E --- # Iowa State University