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[59M]What is best method of determining if prostate cancer has spread to lymph nodes?

I apologise for making yet another thread with questions. Let me know if I'm asking too much on this forum.

59M

Diagnosis: Gleason 4+3=7, T2c, PSA 7.8.

Some classify as high risk, some as intermediate-unfavorable.

Is PSMA/PET currently best method of determining if cancer has spread to lymph nodes?

Cyberknife (SBRT radiation) doctor suggests 5 radiation treatments without adding hormone therapy or anything else.

If I will do this, I want to make sure there are no mets anywhere else and that it is localised in prostate only.

CT scan shows clean, MRI showed prostate only, but is this the most accurate way to tell?

Can't figure out if PSMA / PET would be useful in giving additional info here.

Cyberknife (SBRT) doc said its not necessary, but other docs online say it could be useful.

  1. At some point research becomes its own end. When and how to break the cycle is not simple and neither is treating this thing called "prostate cancer" which is a complex disease with many treatment options none of which can guarantee 100% success. I decided to move forward with what felt right at the time

    1. My Gleason score was 9 - tumors in prostate - had an MRI - biopsy and a PET scan (WOW was that expensive - Northwestern sent an invoice to my insurance company for $24,000.00!) The PET scan confirmed the cancer in the prostate and showed 3 lymph nodes that may be cancerous - my Urologist said he would be concerned if they were over 1 cm in size - currently I have one that is 0.6 cm and two that are 0.3 cm - my PSA score in April was 18.9 and when the Medical Oncologist had blood drawn on Friday it was now 20.9 - we are starting on abiraterone 250 mg with prednisone and lupron - in late November I am scheduled for 5 1/2 weeks of radiation therapy. The hormone therapy will go on for 24 months and then we will see where we stand. If your insurance pays for it I would recommend the PET scan (I turned 65 last December and have Medicare Parts A & B plus supplemental G and I have only paid $266.00 out of pocket, plus premiums and my bills from Northwestern since April are over $60,000.00). Good luck on your journey.

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