How much does tumor size affect survival time? My husband’s MRI showed a tumor 17.5 cm x 7.5 cm – which sounds massive, and is in fact termed only “bulky” in his records. He also has nodal involvement. He’s on Zoladex and has completed 7 weeks of radiation, but are we unrealistic in assuming a tumor of this size can be lived with long term?

You do not give me some key details, like the Gleason grade, PSA at the time of diagnosis. Most importantly, you do not tell me where the involved lymph nodes are. You may want to review my guidelines for submitting questions listed here http://www.prostateteam.com/patient-questions.php as it will help you the next time you write in with a question. In general, the lymph nodes involved would be in the pelvis. IMRT plus hormonal therapy can cure some patients like your husband. During treatment, his PSA should drop down dramatically and it would be best if it fell below 0.2 ng/ml. It will be important to follow his PSA carefully after treatment ends. If the PSA indicates recurrent disease, hormonal therapy may need to be restarted. At AIDP, we try first to slow or arrest PSA progression before we start hormonal therapy.

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Ask Dr. Espinosa

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