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Advanced Prostate Cancer
Center of Excellence
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David Mutchnik
Apr 21, 2015
get psa and follow
radiation if psa rises
Charles Maack
Apr 21, 2015
The tertiary grade 5 is of concern, not so much the margins since lymph nodes showed negative and I expect seminal vesicles and vas deferens showed same. Because of the tertiary grade 5 PSA should certainly be followed and if level post surgical removal is 0.1ng/ml or over I would expect a period of ADT as well as salvage radiation considered since we would hope continued cancer cell activity remains prostatic bed confined...possibly in pelvic lymph nodes if samples not extracted for pathological review
michael hermans
Apr 21, 2015
is he potent preop? i would like him to maximize continence control. i would get a psa at 3 months and strongly consider xrt if psa gets to 0.4.i would encourage him to see a radiation oncologist to get their rationale for this situation.in my experinence it varies all over the place.
Tarek Osman
Apr 22, 2015
Yes I would advise him radiotherapy after I know the post prostatectomy nadir PSA.
If he refuses radiotherapy I wil follow his PSA every 3 months. Thanks
Marius Markevicius
Apr 22, 2015
I would sent patient to adjuvant radiotherapy. PSA schedule would be after 1, 3, 6, 9, 12 month notwithstanding radiotherapy. If patient do not agree, I would follow him using the same PSA schedule.
Tony Nimeh
Apr 23, 2015
Thank you for your recommendations. Yes, he is potent preop. We will closely follow his PSA and refer him to a radiation oncologist to get the conversation started in case it becomes necessary.
Dec 09, 2024
Pending Moderator approval.
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David Mutchnik
Apr 21, 2015
Charles Maack
Apr 21, 2015
michael hermans
Apr 21, 2015
Tarek Osman
Apr 22, 2015
Marius Markevicius
Apr 22, 2015
Tony Nimeh
Apr 23, 2015
Dec 09, 2024
Pending Moderator approval.