I decided for "double play" treatment of 23 sessions of IMRT plus LDR brachy.
In June, after my first biopsy, my prostate size was estimated at 40 cc. In August, after my mpMRI, my prostate size was estimated at 41.5 cc. After various testing anomalies that required various retests, today was the day for my CT simulation and volume study, the last set of tests before treatment started-- or so I thought.
I was really looking forward to getting the treatment show on the road. But the RO said the CT simulation showed the prostate was much larger-- at least 80 cc and maybe 90 cc. He said I was too tight to insert the ultrasound probe all the way for the volume study, preventing an accurate final measurement, but called off the volume study in any case when it became clear that my prostate was too large for brachy.
I was floored, and asked the doctor how an mpMRI could be so off on on the prostate size. He said he didn't know, but the bottom line is that the CT simulation and the volume study are the most accurate, and supersede the MRI.
He offered 2 options: 1) a 3 month Lupron shot, to try to shrink the prostate down to an acceptable size for LDR brachy (55 cc or less); or (2) if that doesn't work, 39 sessions of IMRT, including a second 3 month Lupron shot.
I told him I was still eager to do the double play, and would go for Option 1.
But in reality, I am feeling pessimistic that more tests and procedures will just lead to more tests and procedures, and maybe I should just cut out the LDR brachy, and go for straight IMRT or (my preference) SBRT, where repeat uroflow tests, repeat CT simulations, and prostate size estimates won't derail my treatment and put me into straight IMRT anyway, except with a lot more tests and delays.
Am I missing something?
Ideas? Thoughts? Suggestions?
Post Edited (RichBinSD) : 11/16/2018 8:38:29 PM (GMT-7)