For what its worth, I've recently come from the first, truly thorough consultation that I've yet to have with a qualified radiation oncologist, and he has proposed the following (approximate) schedule for me:
Casodex (for 4-weeks prior to Lupron): 6/15/18 - 7/15/18
Lupron: 7/15/18-01/15/19 (6-mo. dosage, administered 8-10 weeks prior to seeds, for a continuous total of 26-weeks) **
Permanent LDR (Pd-103 = Palladium-103) Seeds: 09/15/18
IMRT: 10/15/18 ~ 12/01/18 (5-6 weeks in duration and 1-month after seeds)
** Note that he is suggesting a cessation of ADT/HT after only a 6-month period (not 2-3 years as often proposed)
As I've said, this has just been proposed to me very recently, and I am still researching and evaluating whether this is the best overall course of action for me personally, given my 'high-risk' Dx, but at this point, its very likely to be the approach that will be taken in my case (i.e., seeds first, followed by IMRT, followed by continued, but short duration ADT/HT).
And lastly, I should close by clarifying that whether or not doing seeds before or after IMRT was even an option (or a viable approach?), was never really discussed. So this is something that I will need to discuss with him and continue to research on my own before agreeing to move forward with it.
Age at Dx: 65
Current Age: 66
Diagnosis (01/18): High-Risk PCa
PSA (04/17): 15 ng/dL
DRE (3x): Nothing found
Biopsy (01/18): 6/12 cores '+' (5-65%)
GS-9 (Initial): 4+5=9, GS-8 (2nd Opinion): 4+4=8
PSA (03/18) post-biopsy: 40 ng/dL
CT, Bone & PET Scans: Normal
3T-MRI: 1" diameter nodule (no lymph or seminal vesicle involvement)
PSA (06/18): 67 ng/dL
Tumor Stage: T3a/T3b?
ADT/HT: Casodex (06/18)
Post Edited (Balladeer) : 6/21/2018 7:18:35 PM (GMT-6)