Has RT Failed

your 2 part question was asked of our wonderful guest Onco yesterday, is there a direct relation between increasing PSA and size of tumours ...simple answer NO .

Can an isolated and identified met be treated by RT or cyber knife ..yes although if the recurrence is in the same place where RT has been used previously there can be some risks involved.

So quite good news it would seem.

Best wishes

xx

Mo

I don't knoww of anyone personally, but J was quick to say Yes to your question about using RT curatively to small individual recurrence mets. So I have to assume he has either done this himself or he has seen reported cases of it.

Of course you have to remember he is not giving specific advice he cannot do that without seeing all the information so this was a generic answer.

Best wishes

xx

Mo

Hi Roy,

Sorry to hear about the PSA rise, I found your link fascinating so thanks for that.

BFN

Julie X

Thanks Lyn for the additional info from J. The point regarding only treating it if it is singular surprises me, as I believe that in other countries upto 5 areas are able to be treated and in this country upto 3 areas can be treated although there are not many even willing to do that, but I suppose like everything else it comes down to resources etc. I do think some Oncologists are too quick in following the palliative path and follow the NICE guidelines, rather than go for a durable remission.

Thanks. Julie I am pleased you found the video informative as I hope other people find it helpful.

Hi Dave I share your concern regarding treatments undertaken without definitive proof of where the cancer is situated, surely this cannot be of benefit to the patient and the NHS budget. Was your Treatment IMRT and only focused on the prostate bed or was the treatment area more wide spread to catch any theoretical spread elsewhere in the abdomen, as the more focused approach would have been better for future RT. I do hope your lymph node treatment is successful and you can then put this all behind you, so please keep us informed.

Thank you all

Roy

Just had a call from my Oncologist after my persistently chasing him as regards my scans treatment etc. I get the impression that he is trying to shut the door on any treatment to the pelvis as he says the spread which is now 1cm in size is in a difficult place and hard to get enough radiation to the area,due to the placement of the bowel, but on pressing him it came out that the radiologist planner has not even seen the scan as he is on holiday, so it's back on hormones and keeping the pressure on him to come up with the goods. He should know by now I won't take no for an answer, it's my life I am fighting for.

Roy

Hi Roy,

It can be difficult to deliver RT to a particular area without the risk of damage to nearby organs because of the location and the nature of Photon RT. This would include Cyberknife. Where cancer has been located, It might be possible to attack it with Proton Beam which can unload on the cancer rather than Photons which cause collateral damage on the way to the target and after it. Another possibility is Nanoknife (irreversable electroporation) which does not rely on radiation or heat. Unfortunately, both of these treatments are not presently available the UK for PCa and many UK consultants are reluctant to refer patients abroad for such treatments.

Although the recurrent cancer in my Prostate has been treated with HIFU, I have a very suspicious Iliac Lymph Node which HIFU cannot treat and it has been proposed to deal with this deal systemically by HT. However, before starting HT I want to explore any other possibilities.

I am presently awaiting an answer from a clinic in Germany on whether they will treat a single Iliac Lymph Node with Nanoknife
and if the answer is no, I will then approach another facility in Germany on treating with Proton Beam.

Hi Roy,

I go back to the link you gave:- https://www.youtube.com/watch?v=NkqizmvqJPo

This is a very interesting lecture by Dr Kwon of the highly respected Mayo clinic. I accept very much his line of thinking not to rely on HT to deal with hot spots as this may shrink and contain the cancer for a time but will allow resilient cancer cells to mutate and to set up colonies elsewhere. As he says, the best course of action is to treat an isolated site or a small number of sites at the earliest opportunity. I would be happy for Dr Kwon to treat me if I could not get effective treatment in Europe but unfortunately the cost and logistics of going to the USA pretty well rule this out.

It may interest you to know that I have received a reply from my contact in Heidelberg advising that they might be prepared to treat my Iliac node with EBRT plus a Proton boost provided it was in the pelvic area, that they are given my histology and scans and that I have HT for 3 years starting 2 months before the RT. How much RT I would need has not been stated at this preliminary stage. (I am rather surprised because I have already had more radiation than I would have been permitted had my original RT been in the UK). This is more restrictive than the treatment given by Dr Kwon because he treats hot spots in places not confined to the pelvic area and not always requiring HT.

Unfortunately, the clinic in Germany who claim to be the only one there who treat PCa with Nanoknife have not replied to my 2 emails . so I will give them a ring. I would prefer this to further radiation if suitable.

My only other thought is to go back to the Marsden who I believe have Cyberknife and ask them whether they would treat my Iliac node with it.

We are in a similar position except your hot sport is in bone and mine in a node. I will let you know how I get on and would be grateful if you would do the same. Have you tried the Proton Beam centre in Munich?

Edited by member 21 Aug 2015 at 23:29  | Reason: Not specified

Thanks for the posts.

Barry I will try the centre in Munich to see what their response is regarding treatment to bone. I am pleased you have a possible solution to your problem and you are researching even more options, I know the QE in Birmingham has the Cyberknife and that maybe it could be possibility for me but like anything on the NHS there seems to be little urgency or am I impatient?.

Hi Si, thanks for the info my stats are:

ALT 18

BILI 7

ALP1 81

ALB 50

CA 2.43

These have been within limits since the start I think, PSA seems the only indicator. It's good to see you are doing well judging by your comments Regarding having no questions for Jamie. I think the only question I would have is, if all restrictions were to be taken away by NICE and all options were on the table ie meds, machinery etc would he be more innovative in your treatment.

Good luck to both of you and thanks once again, and I will keep you updated as things move forward.

Roy

Hi Dave,

You are right on the Marsden having Cyberknife which can treat tissue and bone, so is a possible option for both Roy and myself.