Lung Biopsy or Not?
Summary of my situation: Gleason 4+4=8, Cancer has escaped the capsule and infected a nearby lymph node. Also "innumerable" small nodules in the lungs consistent with metastatic cancer from unknown promary. PET PSMA scan only dimly lights up the prostate and lymph node. No other area of the body light up (not even the lungs). Started to see the specialists and this is where I've landed:
Urologist referred me to pulminologist (lungs) who said he has seen more nodules appear since last scan and referred my to a cardio-vascular surgeon who suspects the lungs are melanoma but wants to do a biopsy to confirm. This will be a 5 day hospital stay because they need to go in through the ribs. Admission scheduled for this coming Sunday. He referred mt to an oncologist who I saw today.
The oncologist said "not" to do the surgery and go onto ADT instead, then review in 2 months. If the lungs improve then it's probably prostate cancer in the lungs, if not then it's some other for of cancer (which would have had 2 more months to grow in my lungs).
I then messaged my original urologist what to do and he agrees with the oncologist to delay surgery (one line reply, no explanation).
However this leaves my in a situation whereby the specialists are giving conflicting advice. If I delay the biopsy and it's not prostate cancer in my lungs then I give it 2 more months to grow (and melanoma grows fast).
My bias is to override them and do the biopsy to give me certainty on what is in the lungs. However it is a very invasive procedure and I will be out of action for about 6 weeks - at the very time I should be excercising to counter the ADT therapy.
Nobody seems to be captaining the ship and it's up to me, the patient, ot make these calls.
Anyone gone through anything similar and any suggestions?