crappy news

Video meeting with RO today. I was excited about the PSMA scan report because it showed once again no organ or bone involvement, but 2 small lymph nodes.
I was hoping we could once again play wack a mole via SBRT
UNFORTUNATELY, they are in the same area previously radiated. He is willing to do it, but there is an increased risk of damage.
He left it up to me. So, I need to look at options . Video appt. with Dr. Lam on the 7th.

Mel

Comp man,
Look on the brighter news(as if there is anything "bright" about PC)

"no organ or bone involvement"

I dont know but I am sure Dr. Lam will. Maybe keep zapping those spots!!

If only you could consult Dr. House and Dr. Wilson..lol...been watching those reruns on Roku lately!

Wingin It
aka Dan in So Cal

I had a PSMA scan awhile back and found it in a couple of lymph nodes also, one to close to my esophagus to radiate, so i am on on lupron shots and xtandi pills, so far my PSA is.1 terry

Tough one. A little surprised that the docs will give you the option. Not completely fair to put it on the patient, but I suppose in the end it is always on the patient. I hopped on the SBRT wagon starting yesterday, going after a hot node close to the rectum wall. Hopefully in time to prevent spread into the wall. Finish my five on Sept 30. Wishing you the best… Bill

My post wasn't clear.
The two small hot nodes are located in an area previously radiated.

Mel

Maybe proton beam for small isolated targets? You may be getting old enough where the extra radiation risk is minimal unless adjacent to something that is real important. Just guessing on my part….

Mel, sorry you are having to deal with this again. I know nothing about what you have now to deal with. Just curious if lymph nodes can be removed after being radiated? I know it is difficult to do that with a previous radiated prostate, but haven’t heard discussions about lymph nodes. It does look like, at a minimum, continued ADT until it doesn’t work could be suggested. I know Matt suggested in a earlier response in maybe changing to one of the newer ADT drugs. I believe Orgovyx is now becoming more popular in treating aggressive PC. In any case, I am hopeful your doc will come up with a treatment that will continue to work. My best you Mel,
Jack

Mel, I don't know enough about the subject to offer any thoughts, other than that I'm sorry you're having to deal with all of this and are being forced to make these tough decisions.

In answer to questions:
"there are 2
new nonenlarged lymph nodes with intensely increased PSMA expression,
one in the left periaortic region at the level of L2-L3 disc space, SUV
max 44.0, and another anterior to the distal aorta, SUV max 12.3."...

"Two new nodal metastases with intense PSMA expression in the lower
retroperitoneum/para-aortic region, as described in the report body."

The RO did offer "agressive tx." but indicated risk of damage. He basically indicated he would do it "if that's what I wanted" but seemed to be saying he didn't recommend it.
I assumed those SE would be immediate. I did ask about surgery and he definitely advised against it. I'm going to message him and ask about the timing of the SE.

PSA going in was 2.0

Mel