I'm interested in conversations about and I want to talk about

Know exactly what you want?

Show search

Notification

Error

Salvage radiotherapy enlarged lymph node

Email this conversation Print this conversation

User

Posted 27 Sep 2023 at 16:44

Hi all.

Just found this after some honest opinions.

After a radical prostatectomy nearly three years ago I have a PSA that has doubled in three month to 0.9. With enlarged pelvic lymph node Been offered salvage radiotherapy along with hormone treatment.have to say I'm not convinced I should have this.

Any advice experience?

Many thanks

Nick

User

Posted 28 Sep 2023 at 14:20

If they need to verify prostate cancer in a lymph node, it's usually done by checking for it shrinking on hormone therapy.

User

Posted 29 Sep 2023 at 07:41

Thanks Chris

Hope all is ok with you.

Many thanks for info ill follow up with call

Take care

Nick

Show Most Thanked Posts

User

Posted 27 Sep 2023 at 17:27

Nick,if your PSA was 0.45 three months ago why were you not given treatment then. When my PSA was around 0.25 three years after surgery I was offered salvage RT, I asked for a PSMA scan but was refused, scans were a relatively new idea after recurrence in 2017.

My PSA did drop after SRT but then started to rise again, in the last 18 months they have found two separate cancerous pelvic lymph nodes, each of which were treated one last year, one this year. At 0.9 you are well over the lower limits for having a PSMA scan.

There is a risk that if something is found out side the prostate bed that choice of treatments can change.

Are you sure the figure is 0.9, do you have a list of your previous PSA tests.

Thanks Chris

User

Posted 27 Sep 2023 at 21:53

Thanks for reply.

Yes psa was.. 0.45 then two weeks after went to. 0.5 consultant sent me for another test and it dropped to 0.47.

Obviously im no doctor she said would test in three month. Psa has gone to 0.95 sorry.

Unable to decide if i have treatment or not i then got told they found an enlarged lymph node back in june.

I asked for a scan before i decide wether to have treatment or not, the consultant said its not necessary

Thank you again

User

Posted 27 Sep 2023 at 22:18

Nick, are you in the UK, your treatment does not seem to meet normal UK protocols ? You would expect salvage RT to start at roughly around.0.2 to 0.3. How did they find the enlarged node. Have you refused treatment.

Thanks Chris

User

Posted 28 Sep 2023 at 11:08

Hi chris

Yes in the uk.

I had a scan in june to also check growth on my adrenal gland and lymph nodes.

I only found out about this after my consultants second telephone call.

This was when my psa went to 0.95 she told me relooked at scan to notice adrenal gland, doesnt make sense i know.

Not refused any treatment i have taken consultants advice.

My concern is from june to late September what has altered and is treatment just to prelong rather than cure?

Thanks

Nick

User

Posted 28 Sep 2023 at 11:12

Hi chris

Sorry growth on adrenal gland apparently no change.

Concerned you say treatment should have been offered as psa was 0.45 in February.

Looks like i may have missed the boat

7 months is a long time.

Have you had successful srt and hormone treatment?

Cheers nick

User

Posted 28 Sep 2023 at 11:33

The salvage radiotherapy is a treatment given with curative intent.

You could ask for a PSMA PET scan first, although they might refuse or say the waiting list is too long to safely wait. That could identify any other area which needs radiotherapy too.

However, the PSMA PET scan is a double-edged sward. If they find more than one or two areas, then they probably wouldn't offer the radiotherapy, and you'd be on lifelong hormone therapy because the radiotherapy is unlikely to be beneficial enough to risk side effects. However, if they do the salvage radiotherapy and then later find one or two more mets, they might actually treat these. A bit of a gamble.

User

Posted 28 Sep 2023 at 11:49

Thanks Andy

Ive had psma pet scan showed nothing that was back in april.

Another scan for something else in june showed enlarge lymph node.

Its difficult decision as im aware hormone therapy is somewhat lifechanging

Thanks

Nick

User

Posted 28 Sep 2023 at 14:15

Think I would want a biopsy on that lymph node as it doesn't sound like a conclusive diagnosis.

Will the node be included in the RT field anyway? If not ask why not.

User

Posted 28 Sep 2023 at 14:20

If they need to verify prostate cancer in a lymph node, it's usually done by checking for it shrinking on hormone therapy.

User

Posted 28 Sep 2023 at 14:46

Yes im wanting more investigation really. The lymph node will be targeted but has it left that one moved too others other organs?

Thats my concern as this was found three months ago but only mentioned now.

As bad as sounds if cancer has spread as im told is aggressive. Dont see the point of putting myself through the treatment as it is life changing only to find out later it was waste of time.

After 1st diagnosis and op this changed me as im sure does others. Do i really want to be a different person, even my kids didnt like, for a guess it hasnt spread.

Im sure lots of us have struggled with choices.

Many Thanks

Nick

User

Posted 28 Sep 2023 at 19:54

Originally Posted by: Online Community Member

Hi chris

Sorry growth on adrenal gland apparently no change.

Concerned you say treatment should have been offered as psa was 0.45 in February.

Looks like i may have missed the boat

7 months is a long time.

Have you had successful srt and hormone treatment?

Cheers nick

My salvage RT was given as an educated guess, that is how it was back in 2017. My PSA did drop but then started to rise again, I didn't have HT at that point. I have had further SABR treatment to two separate pelvic lymph nodes. I started on bicalutamide four months and will stop it in two months time. No two cases are the same and what happened to me is not an indication of your outcome.

Have you spoken to the prostate cancer UK nurses, the number is at the top of the page. A two way conversation may prove more beneficial that the to and fro chats on here.

Thanks Chris

User

Posted 29 Sep 2023 at 07:41

Thanks Chris

Hope all is ok with you.

Many thanks for info ill follow up with call

Take care

Nick

Email this conversation Print this conversation

Join the online community now.

Click through to become a member and gain access to support, information and real time replies.