I have been reading a lot about radiation, hormone therapy, and prostrate removal, seems the more I read the more confused I get. Can anyone help me understand why my husbands urologist seems to feel that his PCa is localized and radiation only would be the way to go? (He also conferred with my hubby's attending MD who thought the same). His last PSA was 2.4 does this mean that there is less likelihood that the cancer has spread? Urologist nor attending MD felt anything unusual on rectal exam. I may be jumping the gun and feeling a little anxious because his CT scan is Sunday and the Bone Scan is scheduled for Monday. If there is evidence of mets I am sure he will rethink radiation. The hospital network that we are in does have access to SBRT, I am hoping that my hubby will not have to endure the multiple weeks of radiation. Has anyone on here been dx as G9 and had SBRT? and how well was it tolerated?
at that PSA, it's unlikely scans will show anything. It's possible the docs are right on this one.
SBRT is tolerated very well by most, it's a good choice.
I'll be in the shop.
Age 57, 52 at DX
PSA:
4.2 10/11, 1.9 6/12, 1.2 12/12, 1.0 5/13, .6 11/13,
.7 5/14, .5 10/14, .5 4/15, .3 10/15, .3 4/16, .4 10/16, .4 5/17, .3 10/17
G 3+4
Stage T1C
2 out of 14 cores positive
Treatment IGRT - 2/2012
My latest blog post
SBRT is tolerated very well by most, it's a good choice.
I'll be in the shop.
Age 57, 52 at DX
PSA:
4.2 10/11, 1.9 6/12, 1.2 12/12, 1.0 5/13, .6 11/13,
.7 5/14, .5 10/14, .5 4/15, .3 10/15, .3 4/16, .4 10/16, .4 5/17, .3 10/17
G 3+4
Stage T1C
2 out of 14 cores positive
Treatment IGRT - 2/2012
My latest blog post
With his lowish PSA, it's a good bet that it is still localized and nothing will show up on a bone scan or CT. Some kinds of prostate cancer don't put out much PSA, so it's a good idea to have the scans, just to be sure. You are right that if they find any metastases, his next step would be hormone therapy rather than radiation.
Assuming the scans are clear, the GS 9 puts him into the "high risk" category. The therapy with the best cure rates for high risk men is a combination of external beam radiation with a brachytherapy boost to the prostate and some hormone therapy. The external beam part of that typically involves 4 weeks of daily radiation. The strong dose to the prostate comes with a possible increase in urinary side effects. It can be done without the brachytherapy boost, but it will then be 8 weeks of external beam radiation.
SBRT is only used experimentally for high risk patients. In fact, Arica Hirsch at Advocate Lutheran Hospital is running a clinical trial. Her protocol still involves 4 weeks of daily radiation, however. A few ROs in the country are treating high risk patients with just 5 treatments, but i don't know of any in the Chicago area.
Also in the Chi area, you have Brian Moran at the Chicago Prostate Center, who is one of the most expert brachytherapists anywhere. He would be a great choice to do the brachytherapy part of the combination treatment. You can have the external beam part done in any convenient location.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
•SBRT 9 yr onc. results •SBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.1,no lasting urinary, rectal or sexual SEs
my PC blog
Assuming the scans are clear, the GS 9 puts him into the "high risk" category. The therapy with the best cure rates for high risk men is a combination of external beam radiation with a brachytherapy boost to the prostate and some hormone therapy. The external beam part of that typically involves 4 weeks of daily radiation. The strong dose to the prostate comes with a possible increase in urinary side effects. It can be done without the brachytherapy boost, but it will then be 8 weeks of external beam radiation.
SBRT is only used experimentally for high risk patients. In fact, Arica Hirsch at Advocate Lutheran Hospital is running a clinical trial. Her protocol still involves 4 weeks of daily radiation, however. A few ROs in the country are treating high risk patients with just 5 treatments, but i don't know of any in the Chicago area.
Also in the Chi area, you have Brian Moran at the Chicago Prostate Center, who is one of the most expert brachytherapists anywhere. He would be a great choice to do the brachytherapy part of the combination treatment. You can have the external beam part done in any convenient location.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
•SBRT 9 yr onc. results •SBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.1,no lasting urinary, rectal or sexual SEs
my PC blog
Bjj0619
I am a GS 9 and I just completed SBRT at the end of August at MSKCC. Since I am a GS9, the treatment plan became a triple play of ADT, LDR brachy and then SBRT. I probably went into the SBRT with some residual side effects from the brachy, but it was not a bad experience. My treatments were 5 fractions over 5 days. Total time on the table for each treatment was maybe 15 minutes. SE included some bowel issues incuding frequency, which are diminishing and some slight burning during urination which only lasted a few days. Remember, everything is getting toasted in that area so some issues are to be expected. Your husband may go through with minimal SE's. Everyone is different and their bodies react differently. GS9 is an aggressive, high risk cancer and quite a few GS9 guys opt for this type of treatment plan to basically throw everything at the cancer. I believe in most GS9 cases, the thought is that if the cancer has escaped the prostate, and is in or around the prostate bed, surgery may not get it all. Radiation in that case would be a better option. If you choose surgery, chances are that radiation would be needed a few months later if it has escaped. Why go with surgery and its SE's only to have to do radiation and deal with its SE's months later.
Age at Dx. 63
PSA 1/08 1.4, 12/16 12.17, 4/17 3.8, 7/17 1.05, 10/17 <.05 (HT)
GS 9 (4+5)
CT Scan and bone scan 1/17 both negative
2/2/17 prostate MRI.
2/27/17 pelvic bone biopsy done. No mets
3/7/17 Started HT. Degarelix, 4/17 lupron (1-2 years)
7/7/17 LDR Brachy (Zelefsky MSK)
8/25/17 SHARP (SBRT) finished at MSK
I am a GS 9 and I just completed SBRT at the end of August at MSKCC. Since I am a GS9, the treatment plan became a triple play of ADT, LDR brachy and then SBRT. I probably went into the SBRT with some residual side effects from the brachy, but it was not a bad experience. My treatments were 5 fractions over 5 days. Total time on the table for each treatment was maybe 15 minutes. SE included some bowel issues incuding frequency, which are diminishing and some slight burning during urination which only lasted a few days. Remember, everything is getting toasted in that area so some issues are to be expected. Your husband may go through with minimal SE's. Everyone is different and their bodies react differently. GS9 is an aggressive, high risk cancer and quite a few GS9 guys opt for this type of treatment plan to basically throw everything at the cancer. I believe in most GS9 cases, the thought is that if the cancer has escaped the prostate, and is in or around the prostate bed, surgery may not get it all. Radiation in that case would be a better option. If you choose surgery, chances are that radiation would be needed a few months later if it has escaped. Why go with surgery and its SE's only to have to do radiation and deal with its SE's months later.
Age at Dx. 63
PSA 1/08 1.4, 12/16 12.17, 4/17 3.8, 7/17 1.05, 10/17 <.05 (HT)
GS 9 (4+5)
CT Scan and bone scan 1/17 both negative
2/2/17 prostate MRI.
2/27/17 pelvic bone biopsy done. No mets
3/7/17 Started HT. Degarelix, 4/17 lupron (1-2 years)
7/7/17 LDR Brachy (Zelefsky MSK)
8/25/17 SHARP (SBRT) finished at MSK