75Tiger - here's a link to the G9 Crew. I've entered you on the roster there. It's a gathering place for those of us facing this diagnosis, and the treatment decisions that go with it. You'll find many forum names there, and links to a lot of the initial posts by many of them.The Gleason 9 Crew -- Part 2, continued.
Your case does have quite a high tumor burden, with seminal vesicle involvement. Did the insurance say why they felt IMRT not to be medically appropriate? It seems to be exactly what most here would suggest. Where are you located?
[Edit: didn't realize it was metastatic, so that makes a difference in doing local therapy. That's much less clear.]
Bx: 6/12 pos, G9=5+4 (80%, 60%), 4+5 (2@100%, 80%, 10%), PNI+
cT3a (3TMRI: Bilateral EPE, NVB+, SV-, LN-)
Date PSA fPSA
9/12 4.1 15%
3/13 5.2 12% PCA3=31
IGRT by IMRT, 44 done 8/28/13: 50.4 Gy pelvic nodes, 79.2 Gy prostate
ADT2 3 yrs: Lupron/Casodex, ended 3/16
Post: (age now 59)
PSA <0.1 : 8/13 - 5/16.
PSA 0.2-8/16, 0.5-12/16, 0.7-3/17, TBD-6/17
Post Edited (Redwing57) : 3/28/2017 5:34:44 AM (GMT-6)