Topics:
Radiation Oncology • Genitourinary Cancers
How do you approach a prostate cancer patient with oligomet disease on PSMA PET?
Would you biopsy the metastatic lesion?
Would you treat prostate definitively and monitor closely?
Would you treat prostate and oligosites?
Answer from: Radiation Oncologist at Academic Institution
I think there is a spectrum of 'PSMA-PET Avid lesion suspicious for metastasis'. In some locations, such as ribs, I worry more about false positives. For lesions with PET avidity without CT correlate, I worry about false positives and may advocate for a biopsy if it will change the treatment plan. S...
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Answer from: Radiation Oncologist at Academic Institution
I would try to biopsy the site to prove metastases. Always a good idea to prove the first metastasis with a biopsy. Assuming it is proven or I am convinced it is real, such a patient is not someone who would have qualified for studies showing a benefit to SBRT (SABR-COMET, STOMP, ORIOLE). So, I woul...