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Dr. Andrew Rynne

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Suggest treatment for minor mestateses in spine, hip and rib cage

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Dr. Jawahar Ticku

Oncologist

Practicing since :1979

Answered : 431 Questions

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Posted on Mon, 25 Aug 2014 in Cancer
Question: Background: Bone Scan identified minor mestateses in spine, hip and left rib cage. Doing Ct Scan tomorrow. Doctor is saying treatment likely to be a Lupron Regimen. My concern is that Lupron focuses only on decreasing Testerone. Another local cancer center focuses on using stereotactic body radiation thereapy. My doctor seems disinterested in that approach. Whree do I go for comparative analysis? Thanks
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Answered by Dr. Jawahar Ticku 8 hours later
Brief Answer:
Prosttic carcinoma hormonal management

Detailed Answer:
Dear,

Prostatic carcinomas are hormone dependent i.e., testosterone. We have to give a chance to testosterone reducing agents one of which is lupron. In addition to this you can use bone modifying agents like zoledronic acid or bone calcifying agents like Alphacalcidol so that the metastasis to bones can be delayed. A Radiation Oncologist will advise steriotactic radiotherapy which is his main tool. If the prostate does not shrink with hormonal therapy radiotherapy can be tried.

You need to have blood testosterone level to know if you really have high level of testosterone. If testosterone level is minimal and still the bone lesions are increasing possibly you are a case of castration resistant and lupron has no value. In such cases you may need steriotactic radiotherapy.
Also chemotherapy systemic may be needed which your oncologist will determine. This treatment is to be supplemented by bone modifying agents.

Initially you have to give trial to hormones particularly lupron depot.

Truly,
Dr. J. Ticku
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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