Today, I came back to be to the radiotherapist. His level of empathy and communication are just the opposite of the well-reputed urologist-surgeon that I visited a couple of days as reported in my thread about
I asked him about
the paper I read about
a HDBT single fraction monotherapy cohort elsewhere here in Spain that showed poor progression survival. His reply was that he instead uses two fractions implants at 6 hours interval. He showed me his patient statistics, private or included in congress seminars and planned publications (it is very rare in this country that any doctor discusses or gives that information). In seven years he has treated about
170 low and intermediate risk patients and has had a single case failure. This single case received salvage surgery and the pathological report revealed a G10 focus. (This patient seems to be all right now).
I understand that HDBT as monotherapy still has some experimental flavor and that treatment failure data takes some time to mature after radiation but, anyway, I am very impressed with his statistics.
I asked him also about
SBRT. He confirmed me that in their protocol the patients have a cathether for five days. He has appointed me with the doctor that uses cyberknive in their Center. It is not covered by my insurance but the cost is not as high as I imagined.
Up to this point, I think I have been doing everything it is required to take an informed treatment decision but I am still doubtful about
what it will be. Sometimes I have the challenging thought that if I finally do not follow the conventional choice (surgery) will be not because of my research but because it frightens me too much. Right now, it seems I have PCa and a big headache
67 years old.
PSA: 2008:2.8; 2012-2016: 4.5-5.5 with a couple of high peaks (up to 9.1).
May 2017: 6.1; July 2017: 7.6
mpMRI, July 2017: left medial apex posterior PIRAD5 5 with some capsule abuts.
Dx August 2017,Gleason 3+3, two cores, left 5%, right 3%, greater tumor length: 3.5 mm., left.
Prostate size 2017: TRUS: 71 c.c.; mri: 98 c.c.
DRE: increased consistency left side, september 2017.
Post Edited (jmadrid) : 9/28/2017 7:48:00 AM (GMT-6)