I had prostate surgery in 2023 followed by salvage radiation therapy. My PSA just exceeded 0.2 this week and I will have a phone visit with my Uro soon about what’s next. I think he will be pushing me towards some sort of ADT meds at some point. I’ve read about focused radiation therapy, directed at Mets discovered using PSMA-PET/CT scans. Have anyone on this forum had this procedure and if so how did it work out?
Hello - I might suggest that you seek out an oncologist with PCa experience for continued care. In any case, I would not do any ADT until after MRI and PSMA PET scans have been evaluated.
A number of men here have had directed RT to locations indicated by advanced scanning. The results seem to vary a lot as once spread is noted, the full extent cannot be determined but it is the best shot one has to aggressively fight the disease.
The “oncologists” seem to be categorized as “medical oncologists” or “radiation oncologists”. Let me guess what the advice one would get from each category. I would like to avoid ADT side-effects for at least a few years providing targeted radiation can suppress any Mets causing PSA to rise. I am suspecting I will have to go out of network to get the PSMA-pet scan and highly focused RT because my current provider likely does not have the needed equipment here. One more hurdle is that the current administration has designated my state (WA) as one that will require extra review for Medicare coverage of certain procedures, likely these two. I’m not a billionaire, but should be able to cover it..but feel for those who may not.
Depending on scan results, you may find shorter term ADT recommended in addition to targeted RT. Most probably, nothing will be found at PSA = 0.20 so you wait.
All of those not in a larger metro area or medical university town will have an issue with specialized diagnosis and treatment. Same for those who do not have the best Medicare plans regarding options. Seattle is a great medical town so lots of options not too far away.