Comet 10 trial.

User

Posted 31 May 2023 at 12:57

I wondered if anyone has any experience of the Comet 10 trial involving SABR radiotherapy to oligo metastatic lymph nodes.

My story in short form is below:

Diagnosis of advanced metastatic PCa in Sept 2020 with PSA of 248. (Damn the NHS for not having a screening program and I had no idea it was possible to have PCa to this level and not know about it).

6 doses of RT to prostate and later RT to para-aortic LN's. Also Zoladex 12 weekly and was on Enzalutamide.

Now I am hormone resistant and though my PSA went down to 0.2 it is now back over 300.

Presently I am having Docetaxel and just had my 4th cycle. PSA does seem to be coming down a little but early days.

My pathology is now that I have mets in my supraclavicular and mediastinal lymph nodes and in my pancreas (all extremely uncommon) together with some mets in some pelvic lymph nodes. I did have to have a biliary stent put in as the pancreatic mets obstructed my bile duct and induced a horrible jaundice! I am now 66 and still extremely fit despite all this pathology. I have never had any real evidence of bone mets apart from some slight changes in some vertebral density on bone scans.

I feel like it would be a great idea to hit the mets at this stage with some SABR and know that the Comet 10 trial is running. I wondered if anyone had any experience on this. I also keep asking about getting a PSMA PET scan but have not convinced the oncologist to let me have one yet.

I feel like I am beginning to run out of options but still hopeful that the Docetaxel will buy me some more time and will also open up the possibility of getting some Lutetium 177 in the future. I may be able to get this in Australia and there is also a trial running in Australia (Evolution trial) that I may be able to access.

Any helpful comments or advice are welcome.

Mike.

User

Posted 31 May 2023 at 21:26

SABR tends to only be offered in the UK if they are really confident that there is only one or two mets. Chris recently had SABR to a lymph node but it didn't work and now he has other nodes - a second lot of SABR may be available for the new ones but not the original. Hopefully, he will post a response to you.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 31 May 2023 at 22:29

Mike ,I had SABR to a tumor last year as Lyn said. The PSA carried on rising and a second scan showed up another tumor and a residue of cancer in the previously treated tumor. The risk of retreating the original tumor was thought to be great with the risk of damaging a blood vessel or bowel.

The original treatment was done on the NHS and treatment to 3 tumors was mentioned. When further treatment was brought up I told my onco I had health insurance and could We go down that route. I got a PSMA scan done a few weeks earlier by going private and they found the second tumor. The goal posts seemed to move and I was told 5 areas could be treated in the private sector. Then during a conversation that moved to 5 and possibly a couple more.

I had the first of my 5 SABR treatments today.

Look up Dr Kwon and oligometastatic cancer, although in the USA he has some interesting views on treating recurrence.

Hope you get sorted.

Thanks Chris

Edited by member 31 May 2023 at 22:30 | Reason: Spelling

User

Posted 01 Jun 2023 at 10:35

Thanks Chris and Lyn. I am very interested to see how you get on with your recent SABR to 5 or more sites. I am very familiar with Kwon, Schulz and Moyed in the US and follow their you tube videos avidly. The American treatment is a little different sometimes. I also loved the recent comment about Prostate Specific Anxiety!

I am presently getting the treatment I need at the Western General in Edinburgh and I am happy with my onco but I do not want to miss any opportunities with possible treatments and I am happy to pay for treatments if necessary. I know that I have to see how I go on the Docetaxel first but it is difficult to know how much more time the Docetaxel might give me without other follow up treatments.

All best Chris and thanks again to you both.

Mike.

User

Posted 01 Jun 2023 at 11:46

Mike , I perhaps wasn't clear in my description. They found one tumor last year and then found a second tumor this year. On both occasions I had five sessions of SABR treatment to single tumors.

I was trying to point out that under the NHS I would only get SABR treatment for up to 3 tumors, but in the private sector I could have SABR treatment for up to 5 tumors or possibly up to 7 tumors.

Sorry if I have caused any confusion and hope you get the right treatment. As regards paying ,I was warned to check for any limit on my health insurance as the cost could be £12k per tumor.

Thanks Chris

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