Lymph node radiation

It has been a while since I have posted.... after all the treatments (in the signature) my husbands PSA creeped up rather slowly at first and now more steady. 2.9 on 11/20 to 4.9 on 1/28. Went on 1/29 for a 68Ga-PSMA at U of M ordered by our radiation oncologist Dr. Alvaro Martinez. Results came in last night, Dr. saw us today with the results. He wants to radiate the 3 lymph nodes ( not any where near the prostate bed previously radiated ) and also hormone treatment for 12 months. We understand this won't be a cure, but will slow the progression of the cancer. We also were referred to an oncologist who will probably oversee the hormone treatment.
My question is...... should we seek a 2nd opinion at U of M? I think our Dr is really the best but, kinda wonder all the time if there is another option.
Thanks in advance....

Is he going to U of M now or was just the scan done there? If not, it would be a good place for a 2nd opinion. Maybe he should visit with the medical oncologist first and discuss the RO’s plan. Probably won’t change much but once you stop doing radiation for the “cure”, the radiation oncologist becomes part of the team led by the oncologist in a perfect world.

A true second opinion would be to go to a different set of doctors to evaluate his situation. My wife did that at Mayo and they were in completed agreement with the U of MN’s proposed treatment plan after their doctors reviewed scans, pathology, etc. Sometimes the plan is straight forward and all will agree. Other times, there may be some options/trials that were not considered and might be proposed for his consideration.

Good luck with your next steps

Hi djdego. Your date notations aren't quite consistent, so I want to make sure I'm understanding your husband's treatment history correctly. He had a RP in 2015, and the post-op path report showed SVI+, EPE+, SM+. tertiary pattern 5 and he had persistent PSA. He had adjuvant ADT (with no evidence of metastases then other than the high pre-op PSA), but no adjuvant RT -- only salvage RT to the prostate bed two years later? Or have I misunderstood?

Thanks,

Djin

Dr. Martinez is one of the most highly regarded radiation oncologists and PCa specialists in the world. I usually favor second opinions, but I would not require it when you start with him.

Nor would I discourage a second opinion from another very highly regarded PCa radiation oncologist. Just make sure the doctor giving the second opinion is more highly regarded than the initial doctor. Always go uphill, not down hill.

It is like second opinions on PCa biopsy slides. If the first is the local clinic or hospital we most always suggest sending for a second read to Epstein or Bostwick, the two PCa pathologists with the highest regard. If you start with Epstein, no need for a second read as no one is better.

The explanation from our Dr is 2 are higher behind the kidney and one is lower, sorry I don't have the exact location, our Dr said the higher ones are going to be a challenge.