How do you work-up and manage a patient with prostate cancer and a borderline enlarged pelvic lymph node?

How does recommendation change if this a favorable intermediate, unfavorable intermediate or high risk patient? Is additional imaging or biopsy recommended? Do you ever recommend treatment without additional work up?

Answer from: Radiation Oncologist at Community Practice

My approach in this case is to start patients on ADT(and abiraterone if possible) and monitor for LN response with a 3mo CT scan. If LN shrinks, I consider them to be N+ and treat the pelvis, boost the LN if it is still of adequate size to do so (typically >5mm), and continue ADT for 2 years befo...

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Radiation Oncologist at UC San Diego
Agree with the above--well put! I often evaluate w...

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How do you work-up and manage a patient with prostate cancer and a borderline enlarged pelvic lymph node?

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