I share your reservations. If Dattoli has had success with widespread mets, he should publish it, as many would like to know about
"Oligometastatic cancer" is a term that's been in vogue, but there is really very little evidence that such radiation treatment cures anything or even slows it down. But that is when there are 3 or fewer mets. When there are more than that, it's a pretty safe bet that the cancer is systemic. I looked into that case recently:SBRT for oligometastatic recurrence
As you can read there, there was a distant recurrence within 5 years in 85% of the men with just a few mets. Did that treatment slow it down? It's hard to say. How can we know what would have happened without a controlled clinical trial. Again, your father's case is different - he's had multiple known bone mets and LN mets.
One of the members here spoke of a very high radiation dose used by Dattoli for treatment of pelvic LN mets. I don't know if that's what he intends for your father. The danger is that enteric tissue (the kind lining the intestines, which abut the pelvic LN area) is very sensitive to radiation damage. Most ROs, when treating that area, keep the doses low (50 gy for IMRT, 25 Gy for SBRT) to avoid damage to the GI tract.
I acknowledge the possibility of a benefit, but is that one chance in ten? in a hundred? in a thousand? Does it slow down progression? By how much? And what is the risk of damage to other organs? Maybe Dattoli has data, but it hasn't appeared in a peer-reviewed publication.
I also share your reservations about
delaying the start of chemo+hormone therapy. That's something we do have data on from two large clinical trials - CHAARTED and STAMPEDE. If he wants a clinical trial, NIH is running one where they combine chemo+ADT+ProstVac. That seems to me to be much more promising.Docetaxel and PROSTVAC for Metastatic Castration-Sensitive Prostate Cancer
I understand his desperation and desire to go out of the box. Dr Myers is a pretty out-of-the-box kind of guy - perhaps it's worth getting his opinion first. I think he should also talk to a more in-the-box radiation oncologist to get some perspective on this. Debra Freeman in Tampa is an SBRT expert, and Constantine Mantz in Ft Myers might also be a good choice for an opinion.