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How do you approach management of a patient with intermediate risk prostate cancer treated upfront with HIFU and intermittent ADT who is later found to have rising PSA and biopsy-proven prostate-confined recurrence?
Is this considered salvage or definitive since HIFU is not standard of care?
Does receipt of upfront HIFU impact ability to perform standard curative treatments?
Answer from: Radiation Oncologist at Academic Institution
These are frustrating situations, and ones I am now seeing frequently as focal therapies have gained traction in the United States. The approach, needless to say, is highly individualized. Often, these glands are quite abnormal in MRI appearance, and there is a concern for fibrosis. My approach is h...
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Answer from: Radiation Oncologist at Academic Institution
I would treat him as a salvage as he has had treatment to his prostate gland. I would make sure that he does not have any evidence of lymph node/metastatic disease with an MRI scan of the pelvis and possibly a PSMA PET-CT scan.
For the treatment, I would recommend that the patient be treated ...
Comments
Radiation Oncologist at Coastal Radiation Oncology
I've treated a number of patients who failed after...
I've treated a number of patients who failed after...
Radiation Oncologist at Cancer Care Centers of Brevard
There's plenty of experience treating salvage cryo...
There's plenty of experience treating salvage cryo...
Answer from: Radiation Oncologist at Academic Institution
RT if it’s local and or regional. Plus ADT, depending on path and extent.
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Radiation Oncologist at Sask Cancer Agency
I came across 2 articles: Ripert et al., PMID 2153...
I came across 2 articles: Ripert et al., PMID 2153...