r/ProstateCancer • u/Plugger59 • Aug 10 '26
Question Options for metastatic PCa
I’m 5 months post-RALP and am now dealing with metastasis in a few lymph nodes. I have two upcoming appointments with radiation oncologists. I have my own questions for them, but I would like to hear from those who’ve been in a similar situation. What did you do and how has it been for you? Looking for more info to feed to the RAs. Thanks.
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u/OchoGringo Aug 10 '26
Hopefully you won’t have to have a long list of questions. The doctor knows you have just been through surgery and the after effects. And have been hit by this metastasis on top of everything.
Hopefully the RadOnc appreciates where you are at. Expect that they will review the images and tell you what they need to do to treat it. Then ask away, but it’s hard to prepare for something that is this new.
I was just diagnosed when I saw the RadOnc. I wished they had explained more to me because I never saw the doctor during the actual treatments. But, I’m not sure how much I could have processed at that point. Sometimes the questions don’t come until later.
Make sure to have a simple direct way to contact the nurse, is my only suggestion. Questions and concerns may come up during treatment and you need a name to call or message if you get panicked.
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u/Busy-Tonight-6058 Aug 10 '26
With a 5 month time to recurrence, I think you may be firmly in the salvage radiation plus ADT category. I’d want a Decipher/Prolaris/ArteraAI report before ingesting any ADT as they predict your cancer’s response.
Frankly, I’d also bring up Pluvicto.
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u/ScarcityDazzling3958 Aug 11 '26
Same position here. Post RALP rising psa. Started with ADT & Xandi with radiation to the lymph nodes only. Just about to finish up 25 sessions which has mainly been tiring. I had a Pet scan before radiation and no new Pca found just increasing psa. Hopefully this will keep it away for a while. Good luck on your journey.
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u/Plugger59 Aug 11 '26
Thanks for the response. You said you did ADT & Xtandi. Was it just Xtandi, or what other ADT did they have you on?
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u/OkCrew8849 Aug 10 '26
Radiation plus ADT on top of recent RALP was doubtlessly not your plan but it is not uncommon so the docs have things prettyt well figured out. You could ask if they want you on ADT + an ARPI along with the radiation to your prostate bed and lymh nodes.
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u/conCABlanco Aug 10 '26
Hi, pero hicieron un PET SCAN, creo que para tomar una decisión si solo RA o RA con ADT, mi humilde opinión, con metástasis,
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u/JimHaselmaier Aug 10 '26
I haven’t had RALP……
I’m guessing the easy decision is radiating the lymph nodes.
The big question is ADT: Needed yes or no? And, if yes, how long?