There has been a lot of discussion on radiation to treat Oligometastatic PCa here in the past. One thread that i recall referred to Dr Kwon at Mayo and his strong belief in this approach. I think (not 100% sure) that was about
radiating BEFORE going to ADT.
Here is a study that addresses this treatment when cancer becomes castrate resistant....https://www.practiceupdate.com/c/81232/56
The link requires a sign on which is free. But if you prefer not to create one, here is the gist of it...."TAKE-HOME MESSAGE
This study evaluated the impact of local radiotherapy in men with oligometastatic prostate cancer. The authors included 15 men with PSMA-PET–detected metastatic (low-volume) castrate-resistant prostate cancer. These men underwent local ablative radiotherapy to either bone or nodal metastatic sites. A PSA response was observed in 73% of patients. Mean time to PSA progression or last follow-up was 17.9 months, as opposed to 2.9 months estimated without ablative radiotherapy.
Based on this, the authors conclude that select men with low-volume castrate-resistant prostate cancer had a meaningful PSA response to local radiation to the lead metastatic site. A randomized trial should be performed to further study the utility of this modality in patients with advanced prostate cancer.
– Gautam Jayram, MD
I am not a doctor, just another guy without a prostate
Dx Age 64 Nov 2014, PSA 4.3
BX 3 of 12 cores positive original pathology G6
RALP with Dr Ash Tewari Jan 6, 2015
Post surgical pathology G7 (3+4), - ECE, - Margins, -LN, -SV (+ frozen section apex converted to negative)
PSA @ 6 weeks 2/15, .<02, remained <0.02 until January 2017, .02, repeat Feb 2017, still .02. May 2017-.033, August 2017- .033 November .046, March 2018 .060. June 2018 .068, July 2018 - .082, August 2018, .078, August 2018 - .08 Start ADT. Sept 2018 Start SRT
Sept 2018 thru November 2018 – T = 4, PSA = <.05
Decipher test, low risk, .37 score
My story.... tinyurl.com/qgyu3xq