tarhoosier has it pegged. There are new PET scans out there that can detect small metastic PC lesions and therefore can be targeted by surgery or RT. After my PET scan 9/18 that showed 2 small LN +, psa= 1.17, Uro/surgeon said RT with ADT would be more successful than surgery because where the LN were was going to be tricky to remove. I have started on RT(28 sessions) and I will continue on ADT which began 9/18 possibly for 6 months, maybe only for 3. The RT focuses on the pelvic area including local LN,(60Gy) and also the 2 LN+ that showed up in the PET scan, (81Gy).
Just because your psa numbers are high post RP does not mean that you have metastasized lesions in your LN or other areas. Every situation is different. My post RP psa was 2.30 and climbed to 8.71 2.5 years later only to drop down to the latest psa number which was 1.17, 6/18 without any drugs or treatments, basically, AS for over 5 years and the only PC that can be detected by the PET scan are in 2 small LN+. Glad now that these lesions in the LN or anywhere can be targeted by the RT which would not have been the case only a few years ago because the PET scans were not as accurate as they are now and these LN+ would not have shown up in the scans. Hope all goes well with your future treatments.
Age =69, 12/12 psa=6.6, DRE, lump on prostate. 1/13 BX, 2 of the 8 core biopsies PCa, G=3+4=60%, 4+3=40% of tumor, CT=NEG, BS=NEG,CS= T2A. RRP with LN, 4/13. BX, 2mm in LN. 13 cc gland PSA= 2.8 6/13, PSA=3.1 12/13, PSA=2.82 3/18, PSA=1.17 6/18, PSMA PET scan 8/18= 2 LN+presacral, 3 weeks Casodex 9/18, 6 months Lupron 9/18, 6 weeks RT 11/18https://daveincoldstream.blogspot.com
Post Edited (slapshot) : 11/13/2018 9:33:38 AM (GMT-7)