Wait for me to finish please. One of these later nodes was para-aortic at the level of the celiac artery. So now I...
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Repeat PSMA Scan (approximately 1 year after left hemipelvis SBRT):
- Two new small but avid lymph nodes on the right side
- One of these was para-aortic (near the aorta) at the level of the celiac artery
- This para-aortic involvement indicates metastatic disease (cancer spread beyond the pelvis)
This is a significant development — the appearance of para-aortic lymph node involvement represents progression to metastatic prostate cancer.
Current Status Summary:
- Metastatic castration-resistant prostate cancer (mCRPC)
- Currently on enzalutamide
- PSA response to prior SBRT (4.5 → 1.2)
- New sites of disease on right side and para-aortic region
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Source Guidelines
NCCN Guidelines for Patients: Prostate Cancer (2026)Browse all NCCN Guidelines for Patients →Related Services
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