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.