Would you consider offering salvage radiation to a patient with castrate resistant prostate cancer who has never had local therapy and has no evidence of lymph node or distant metastasis?

It's hard to give a great answer without knowing more information, such as the PSA, Gleason score, and T-stage at presentation, why he was treated with androgen deprivation alone up front, what AD he was treated with, how long he was under treatment before he became castrate resistant, and what is t...

I have treated patients in this situation several times over the years, and none of them were ever controlled over the long haul. They all appear to fail. Thus, it appears that whatever the changes are that make the prostate cancer hormone insensitive also make it very difficult to cure with RT. Thi...

Great points by Dr. @Dr. First Last and Dr. @Dr. First Last. When I've encountered this, I similarly present radiation with a goal of prolonging time off ADT or delaying progression (vs as a cure for men who present without prolonged ADT after post-prostatectomy recurrence).

If you look at the MEDCAR...

I have treated this scenario previously, and believe radiation is reasonable as it will likely prolong his freedom from progression. This will not cure the patient, and he will almost certainly progress, but I suspect it will slow that progression. This has to be weighed against the suspected toxici...

It would be good to know the age of this patient and what other health problems he has.

Assuming the best-case scenario for now, if his lack of lymph node or other mets is based on a negative PSMA PET/CT, and the assumption is that his prostate disease has become resistant to hormone therapy (rising...