I wonder if the reasoning involves the different machinery?
For example, suppose my local hospital and Ann Arbor (AA) has the exact same equipment.
I go to AA for the planning. I assume they focus their machine on me and make certain calculations.
If I then have it all done locally, even though it's the same machine, might there be some minute calibration differences (and precision is essential).
Also, if the machines are not quite the same, couldn't there be a bigger problem.
Casey -- you hit on a concern of mine. I really like my local radiation expert. But I guess he is a jack of all trades. But he has practiced here for probably 25 years. Let's assume he is very smart and competent. I would HOPE that in that time he has done plenty of SRT with PC patients. It's a tough call. I know our equipment is the latest and greatest. That is very important as it is supposed to have fewer side effects. But if I go to AA I probably get a more specialized radiologist (actually, I'm not even sure of that!). But I would have to drive there each day (2 hours each way). That would get old in 3 days. I can imagine in 4 weeks when I am in pain from radiation burns or rectal bleeding or whatever other juicy radiation problems I develop, such as extreme fatigue. I could, however, rent a place for that time period and come home on weekends. Still, that would be very difficult.
Given that we appear to have a very good local radiologist and the best equipment -- this is THE major medical center for mid-Michigan - my probable decision will be to stay local. For me, local is a 10-minute trip each way.