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SBRT failure , offically

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Posted 12/8/2021 12:25 PM (GMT 0)
Hello all , with the rise in my PSA , doubling in the last 3 months , see signature, I went to VA for a PSMA-PET, pylarify scan yesterday . I got the call last evening that cancer traveled outside the prostate and is in 1 lymph node . With some advise not the VA , I was told that the whole pelvic area should be radiated with maybe a little more radiation to the node rather than just the lymph node itself . I left a e-mail with Dr. Hirsch , my RO who treated with SBRT 5 yrs ago to see what her thoughts are . I suppose I will be on some form of ADT soon and more radiation . Any imput would be appreciated . Thanks SemperFi , JJ
Posted 12/8/2021 1:00 PM (GMT 0)
They found 3 pelvic lymph glad mets after an auxumin PET scan I got a year ago. Uro said no more surgery, no more radiation, kept me on Eligard and added Xtandi. I referred myself to a new Uro, MO and RO.

However....the ORIOLE study suggested I zap them sukkas. I finished my second round of radiation this past March. 106 Gy of salvage + spot, 50 Gy as salvage to pelvic lymph glands and 56 Gy to those 3 hot spots. Quit Xtandi (immediately) last May 29 after it took away my ability to walk that day. (6 months to mostly recover) Will not get the next dose of Eligard scheduled for today. RO says I am off those chems for quite a while, maybe forever. We will be watching the PSA closely. If it returns I will be up for more spot treatment.

RO says that most of the guys he has treated thus are clear of the cancer now. This treatment is very effective within the parameters of 'oligo metastatic cancer', meaning a few soft tissue mets close to each other and the original tumor site.

Hope this helps. smile
Posted 12/8/2021 2:42 PM (GMT 0)
Thanks Trailguy , yes that helps . VA wants me on ADT to start . I havent talked to my RO yet but she , Dr. Hirsch wants the disc and the paperwork of the PSMA asap from VA. I hoped to avoid hormone therapy but will probably have to get it at some point .Thanks Again , JJ
Posted 12/8/2021 3:14 PM (GMT 0)
I too am currently going thru same thing. Had a PSA done in August and it was 1.167. Three weeks later it went to 3.2 (had prostatectomy in May 2020 and round 1 of radiation late 2020). Started hormone therapy in September this year and today just got back from my 11th of 28 treatments. First round they just radiated prostate bed. This time hitting lymph nodes with a sledgehammer as my dr describes it. He’s being very aggressive which is why I switched to him. Did not do lymph nodes or HT the first go round. Dr appears to be very confident that this will do the trick. He said the HT had already significantly shrunk the cells. Pretty excited about that.
Posted 12/8/2021 3:26 PM (GMT 0)
Sorry to hear your cancer may have returned. Although my PSA history is a little bouncy it appears stable currently. I can offer that the PSA reported can be affected by the type of test. One of the labs I’ve used reports a number typically 20% higher than an another. Since I often attend spinning (cycling) classes I avoid that as well as sexual activity a couple days prior to the blood draw. Please keep posting since your experience may help others. Good luck. Terry
Posted 12/8/2021 5:28 PM (GMT 0)
Mine never really left as my first PSA after surgery was .108. Then my baseline PSA before radiation was .574 on 11/5/2020. After 37 sessions of radiation it only went down to .43 on 4/7/2021. At time dr I fired said see you in 6 months. Luckily I took it upon myself to get a PSA drawn on 8/12 instead of waiting the 6 months. It was 1.675 (numbers above were wrong) then on 8/27 new dr did one and it was 3.15. Glad I didn’t listen to my first dr. I’ll keep you all posted as I am not getting another PSA until 6-8 weeks after treatments are over. Currently on Leuprolide/Eligard with a shot every 6 months.

Post Edited (Olmanhunk) : 12/8/2021 10:31:05 AM (GMT-7)

Posted 12/8/2021 7:54 PM (GMT 0)
Did the 2016 SBRT radiation plan from Dr Hirsch include lymph nodes?
Posted 12/8/2021 9:34 PM (GMT 0)
Im not shure on radiation to the lymph nodes , good question . Thanks
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