Topics:
Radiation Oncology • Genitourinary Cancers
How do you approach a solitary pelvic nodal recurrence following definitive radiation therapy to the prostate/SV?
In addition to scans, would you biopsy the prostate/SV?
Would radiation therapy to the untreated pelvic nodes with hormonal therapy be a consideration?
Answer from: Radiation Oncologist at Academic Institution
This is a difficult situation, since the approach may vary depending on a number of factors, including the patient's overall health, the duration from treatment to recurrence, the size of the recurrence, rate of rise of the PSA and the original stage and grade of the tumor. If you're contemplating a...
Comments
Radiation Oncologist at Advanced Radiation Oncology Center
We all have patients with rising PSA's after defin...
We all have patients with rising PSA's after defin...
Answer from: Radiation Oncologist at Community Practice
I agree with @Mitchell S. Anscher's point about making sure there is no distant metastatic disease before pursing any further local therapy. If you have a confirmed isolated nodal recurrence, like @Howard M. Sandler I favor ADT then treatment to the treatable pelvic nodes electively to 45 Gy wi...
Answer from: Radiation Oncologist at Community Practice
Anecdotally, we have had good experience with radiosurgery for nodal recurrence, measured as PSA control and also oligomets in general. It's the whack-a-mole approach
In post-prostatectomy patients with a PSMA scan sh...
I don’t think we know the answer but based o...