Posted on 03/17/2022 1:01:41 PM PDT by ConservativeMind
Men with microscopic evidence of prostate cancer spreading to their pelvic lymph nodes (LNs) following the surgical resection of the prostate and pelvic lymph nodes (LN) are at a very high risk of dying from prostate cancer. Pelvic LN radiation therapy (RT) is a potentially curative treatment. However, no randomized clinical trials have been conducted in men with pN1 prostate cancer to evaluate whether survival is prolonged via pelvic LN RT when the post-operative prostate-specific antigen level is undetectable (i.e., adjuvant) versus the current standard of care, which involves waiting until the PSA becomes detectable (i.e., early salvage).
Researchers at the Brigham sought to understand whether adjuvant compared to early salvage RT could reduce mortality. The team studied a cohort of 17,913 men, median age of 64 years, and consecutively treated between 1995 and 2017 with radical prostatectomy and pelvic LN assessment and then followed for possible treatment with adjuvant RT or early salvage RT. The authors found that adjuvant compared to early salvage RT in men with pelvic node positive prostate cancer was associated with a decreased risk of death, and this reduction increased by 8 percent for each additional positive pelvic LN found at surgery.
"The lack of randomized trial data and the high risk of death from prostate cancer in this patient population compelled us to conduct this study and explore the findings," said senior author Anthony D'Amico, MD, Ph.D., of the Department of Radiation Oncology. "We are excited for men with node positive prostate cancer because our results have the potential to change practice and lengthen their survival."
(Excerpt) Read more at medicalxpress.com ...
Your true cure rate goes up an additional 8% per infected lymph node that gets irradiated.
Thanks for the info. I guess I should be thinking about this stuff now.
Critically important finding. Thank you! Please add me to your ping list.
Ping
I’m looking for a radioactive hot girl to do mine.
Thanks for this important info.
I have lost my Father and a beloved childhood friend to this evil disease :-(
Technically, the study shows the benefit for irradiating the 1-3 node people helps most at the 10 year mark, where it then becomes clear.
I don’t know if I’d be happy with infected lymph nodes for a number of years, when you don’t know when a cancer might show up elsewhere from those “seeds.”
Knowing it helps in all occasions, just not as clearly or quickly with fewer problematic lymph nodes, would push me over to getting the radiation.
If your lymph nodes are clear after surgery, just wait until you PSA is above undetectable, then get clean up radiation.
No reason to get radiation otherwise
This is saying they find microscopic amounts of cancer cells in the lymph glads.
Of course, if your nodes don’t show this, there’s no work left to be done, thankfully.
If there are a few cancer cells left in the lymph nodes, PSA will be detectable with a few months, and then 40 rounds of proton radiation would clean up the rest if the cancer in lymph nodes. That’s what happened with my brother-in-law. His PSA has now been undetectable for close to six years.
This study says your relative has/had a higher likelihood of dying.
I’m glad he didn’t.
This practice is so common, it needed no trial.
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