If ypou are anywhere close to LA, NY or Toronto, you may want to consider SBRT thsi is only 5 fractions every other day as opposed to 7-9 weeks Mon - Fri. I live in FL and still chose this option with Provenge to leverage the abscopal effect.prostate-cancer.org/abscopal-effect/
This was following the sage advice of Tall Allen who you will get to know as you spend time on the forum. Allen is a layman but his wisdom parallels many urologists and oncologists and hsi advice is free.
My RO was Dr. King at UCLA. the only other two RO's that I know of that do high Gleason SBRT are Dr. Allen Katrz in NY and a group of doctors in Toronto that our fellow poster Houseboy used.
The equipment is one of the machines described above. Still requires a full bladder and an empty rectum but no fatugue since it is very high dose ralatively speaking at 8 grays (Gy) times 5 for totaL of 40 Gy versus 79 - 81 Gy total for other forms of radiaton that take so much longer.
Though not identical to SBRT, you can find concepts by looking at a siteCyberknife.com
Don't let the name fool you as Cyberknife is not surgery but a form of radiation using the equipment referenced above, similar but not ifentical to SBRT.
To qualify for Provenge you need two PSA increases at least 14 days apart wich you probably already have. It typically is a two needle operation called Lukapharesis that lasts a little longer than a movie that withdraws blood from one arm. siphons off some white blood cells to be treated to recognize PCa and attack it and immeidately replaces the rest of yout blood. Three days later using only one needle for an hour the treated white blood cells are reinserted. it's 3 treatments every two weeks for a total of one month with the SBRT planned to coincide with the Provenge approximately around the time of the second Provenge treatment.
The vendor Dendreon offers financial assistance for those of us on fixed income below $60,000 and does not factor in your total assets, just your monthly Social Security and Retirement incomes.
Another option after you qualify for Provenge is to go to more high powered hormonal therapy in my case Zytiga that is 4 pills on empty stomach and typically supplemented often by two 5 Mg pills of Prednisone. In my case with the pending Provenge in lieu of Prednisone I received one 50 Mg of Inspra (Eplerenone) so as to not affect the Immune system that Provenge is treating.
Welcome and good luck with your decision.
66 - DX 64 2/13 PSA 3.68 (6 mo doubling) Gleason 9 (4+5)
T1CN0M1B stage IV w. 7 of 12 cores worst ones 70% right PNI
oligometastatic at Dx 5 tumors 1 right sacro, 2 on
T4 & T9, none visible on 5-21-14 whole bodyscan
1st Lupron 4 month 3-28-13,
PSA down was 3.68, Zytiga June 2014
PSA < 0.01, T < 6 on 10/14,
Prostate shrunk from 50.4 to 15.0
Provenge in Sept & SBRT Radiation in Oct