Para Aortic Nodes

Hi !

When talking about radiation and what can be done I would say the least quailified to give expert opinion is a URO. the only good thing he should say is that he will connect you with a ONCOLOGIST that can provide you with information what can be done with radiation or not.

Your mentioning lymph nodes (plural) and my quess is that some of the lymph nodes in question is actually regional nodes, in the pelvic area near the prostate and then they are definitlely possible to radiate which they often are Done together with the prostate or as part of a salvage RT to the pelvic after RP. One form of radiation is WPRT (Whole Pelvice Radiation Therapy)

The para aortic node is a distant one which means this a distant met ( a M1) But even so, it might be possible to use SBRT which is very precise and high dosage radiation and it’s very good at zapping mets if possible. I know the profile ALWAYSHOPE is a master of information and also her husband had SBRT radiation with good efficacy.

But, please start by asking for an Oncologist and defenitely not have a discussion with aUrologist about radiation because they do the surgery of prostate treatment 

Best wishes - Ulf

Hello tmn1966 and welcome but can I suggest you try and get your friend to join the forum as well as we have a lot of help for him in dealing with prostate cancer. Ulf is correct in saying that your friend needs to see an Oncologist who can run through the options available and very often paint a different picture to the Urologist. The para aortic lymph nodes are more difficult to treat with radiotherapy because of their position close to the aorta but this doesn't preclude it provided the right technique is used. When the surgery is not fully effective at removing the cancer or if the cancer had already escaped prior to surgery and set up home elsewhere then the next step is usually salvage radiotherapy or a form of focal therapy to try and eradicate it and keep the patient on the curative pathway. What is available will be determined by how many lymph nodes are involved. My husband had a very targeted form of radiotherapy called SBRT to distant lymph nodes in a very awkward place plus other mets last April and so far it appears to be successful - it is a matter of checking the expertise of the radio oncologist and the machines used to ensure that you have the best possible outcome.

It is nice that you are looking out for your friend who is probably feeling frightened and mixed up as he has already gone through a major operation and has had a lot to deal with during his recovery. The hormone therapy he has been put on does have side effects but it will be putting the cancer into hibernation giving time to sort out the next plan of action. In the meantime try and encourage your friend to keep as fit and active as possible as this will help him to deal with them but there are other tips we might be able to help him with if he starts to experience them like hot flushes or anxiety. Please feel free to ask any questions and we will try and help if we can.