Just a little confused.

Your RO is right. It may very well be systemically micrometastatic, and incurable. However, with cancer identified in your lymph nodes, there is hope that it has not yet metastasized distantly so that salvage radiation with ADT can cure you. It will not happen without salvage radiation. You seem to be taking something I said out of context and misapplying it.

- Allen

But you're in a very different situation than what I was discussing there - you know you have lymph node mets. You may or may not have systemic micrometastases as well, and if you do, the hormone therapy coupled with the immune stimulation from the LN radiation may clear that up too.

For your situation, adjuvant or salvage RT to the pelvic LNs when cancerous nodes have been identified, there are studies that are more apt. This was the subject of two retrospective studies published last year that showed a benefit to salvage RT, and one that showed no benefit. Here are the studies if you want to look at them - they aren't randomized clinical trials:

Impact of Adjuvant Radiotherapy on Survival of Patients With Node-Positive Prostate Cancer

The Impact of Definitive Local Therapy for Lymph Node-Positive Prostate Cancer: A Population-Based Study

Patterns of care and outcomes of radiotherapy for lymph node positivity after radical prostatectomy

That is very different from the situation my RO was talking about - where there are no known mets - and let me quickly add that that was just my RO's conjecture for something to be studied and not what he would do now in actual practice.

- Allen

I wish I had hooked up with my medical oncologist (some almost 5 years now) before I got talked into SRT by my RO at the time. My oncologist believes I am dealing with a lot of micro-mets, due to the amount of PNI in my pathology. I underwent SRT, not only did it not get the remaining cancer (was considered a failure within about 6 months of completion), it heavily damaged my body by being administered incorrectly. Left me with severe chronic pain, chronic fatigue, and destroyed my bladder and bladder neck - leaving me with an Urostomy for life (being totally incontinent on my own, peeing from a stoma in my side into a bag (appliance) that has to changed 1-2 times a week, plus I still live with constant bladder spasms. Meanwhile, my PC is considered Stage III and metastatic.

If a RO told me what you just said, I would walk away from him as fast as I could. You need to get a second and even third opinion about your situation, IMO.

Good luck ahead.