Do you offer adjuvant chemotherapy or abiraterone for patients with high and very high risk prostate cancer with still detectable PSA after radical prostatectomy and lymph node dissection?
Do you offer adjuvant chemotherapy or abiraterone for patients with high and very high risk prostate cancer with still detectable PSA after RP and LN dissection?
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I will recommend reimaging outside conventional CT and bone scans. The goal of imaging is to rule out metastatic disease and (hopefully) identify localized residual disease in prostatectomy bed or pelvic LN and consider early salvage RT. Fluciclovine PET is now commercially available and also PSMA PET is available through trials. The detection rate of fluciclovine PET is ~ 80% if PSA > 2 and declines by 50% for each subsequent 50% drop in PSA below 2. If he is negative by fluciclovine PET, the r...
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I agree with @Dr. First Last
- Advanced Imaging
- Use of early salvage therapy with ADT for 2-3 years
- No role of Docetaxel
A question occurred though, @Dr. First Last. If checking for BRCA, do you advise/recommend adjuvant PARPi?
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