Treating Lymph Node Metastases #ProstateCancer | #MarkScholzMD | #AlexScholz #PCRI

In some types of cancers, the word "metastatic" is associated with other words like "incurable" or "life-threatening." In the context of prostate cancer, however, metastatic disease is almost always more vulnerable to treatment than other types of metastatic cancer.

This is especially true if the metastatic prostate cancer is limited to the pelvic lymph nodes. In fact, for patients with spread confined to the pelvic lymph nodes, there may still be a chance to achieve a cure or a long-term remission, and new technologies are likely to improve these patients' odds even further in the coming years.

In this video, medical oncologist Mark Scholz, MD, discusses how the PSMA PET scan and advancements in treatment delivery are providing physicians with more accurate disease staging and thus more specific treatment selection, which is offering hope that men with these kinds of high-risk and relapse cases will have even better outcomes in the coming years.

0:07 What is the minimum Gleason score for which there is a possibility of lymph node metastasis?

2:09 How do prostate cancer metastases in the pelvic lymph nodes differ from how people usually think of "metastasis" in the context of "cancer," in general?

3:36 What is the limit for the number of metastatic lesions that can be treated with spot radiation?

4:34 If a patient has lymph node metastases, is it a foregone conclusion that they will need hormone therapy?

6:08 Which form of radiation delivery is best suited for "spot radiation" to metastatic lesions?

6:41 What are the side effects of irradiating a person's pelvic lymph nodes with the intention of long-term disease control?

7:51 There are two common categories of men in this situation. One -- men who are newly diagnosed with prostate cancer with metastases in the lymph nodes, and two -- men who have been treated for prostate cancer, and have since relapsed, but without any known or suspected spread beyond the pelvic lymph nodes. What are the similarities and differences between these two categories?

9:34 What advice do you have for patients with lymph node spread for coping with being presented with a litany of options while at the same time facing a potentially dangerous diagnosis?

Don’t know your stage? Take the quiz: Visit http://www.prostatecancerstaging.org

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  Prostate Cancer