Aggressive treatment even if First PSA after surgery is low

Question to the group. I am about three weeks post surgery (path report T3N1, ductal in both prostate and lymth nodes). I met with my radio oncologist for the first time this week. He stated that the cancer was advanced. He then stated that no matter what the PSA level is, I should consider undergoing a mixture of radiation/hormonal/chemo. He stated that recent studies have shown this could encrease the time before the PSA comes back. My first post op PSA is on May 18 with a CT and bone scan on May 23.

I would appreciate members comments. My follow up meeting with the oncologist us on May 24. As of now, I am leaning on treatment no matter what the tests show.

Does your radiation oncologist have experience treating ductal carcinoma? I don't know whether any of the studies he is referring to are applicable to your type of prostate cancer. I don't know how responsive it is to radiation, hormones or docetaxel. It's very important that you talk to someone who has experience in dealing with it before you subject yourself to what may be the wrong treatment. I think I suggested Maha Hussain. If you explain your situation, she might be able to see you quickly. If she doesn't have the requisite experience, she'll refer you to someone who does.

- Allen

As far as I can tell, it does respond to radiation, ADT and docetaxel (see below). Some oncologists may have tried other agents (like platins or growth factor inhibitors).

Metastatic ductal carcinoma of the prostate: a rare variant responding to a common treatment

You're right that this can get very expensive. Check online for manufacturer deals on drugs. Perhaps they can hypofractionate the salvage radiation. The best deal is if you can get in on a clinical trial, but I don't see any on ductal - sometimes big tertiary care facilities like Henry Ford or UMich have some that they don't post.

- Allen