External Radiation Therapy
Good day all
New to this forum. 66 years old and a week ago learned That 3 cores out of 12 have cancer two of them 3+4 and one 3+3.
Little bit of history:I was on finistrade until 6 month ago and last psa while on finistrade was 4.7.
MRI in 2019 identified a lesion pi-rad 4 (13x5mm) but the biopsy was negative with all cores being identified as chronic inflammation.
The second MRI was done in 2021 with report of slight progress of lesion… and then follow up biopsy as explained above.
Urologist thinks due to my physical condition radiation is better than surgery and he was thinking of brachytherapy.
Following The result got a call from oncologist asking for another psa and this psa came with 12.7 (not on finistrade) so as result oncologist suggests due to this psa reading I better of with external radiation for a month.
With that said spacer gel is not approved in my neck of wood..will be having my planning session and ct simulation in a week.
My concern is due to weather condition if I miss session which apparently is not a good thing and also reading different post seems side effects vary from patient to patient.
I would like to hear your experiences in similar circumstances and any tips on going through this, your side effects,…
Thanks
I did 40 radiation treatments + ADT some 5 years after surgery. I did not have the spacer gel and did well with treatment.
You are correct we all react differently and you just do not know in advance how you will react. I was in good shape physically so that may have helped. Missing a treatment is not the best but it happens and did for me. A power surge at the facility closed it down . In my case they just added the extra day at the end of my treatment calendar .
My advice would be to let your MD know of any negative impacts ASAP and do not be that macho guy who says nothing . I did have some issues with hemorrhoids during treatment that stopped 2 weeks after treatments ended. Keeping physically active was very helpful for me as was resting when tired.
Hi
. Has your doctor talked about varying types of radiation therapy? I ask because with a Gleason of 7, particularly with the primary (first number) being a 3, there are a number options available, such as the Cyberknife or proton therapy. This article from our editorial team gives an overview of different types of radiation therapy, with links to more specifics: https://prostatecancer.net/treatment/radiation-therapy. Your doctor should be able to provide additional information and guidance on how they might apply to your case. Wishing you the best and please feel free to keep us posted on how you are doing. Richard (ProstateCancer.net Team) Hello Richard, Dennis and thank you for your feedbacks and all your doing to help the community.
I’ll be definitely posting about my treatment as I go through this..I believe possibly due to Covid and having virtual meeting with instead of face to face so many questions and informations falls into crack..
My urologist first recommendation due to smaller prostate volume (20.7 cc) also Gleason score of 7 (being 3 out of 12 positive, 3+4, 3+4 and 3+3) , also MRI result (Nov 2021) which suggested slight progress (comparison with MRI of two years ago)of PI-RADS 4 lesion on left side and contained within prostate was Brachytherapy.
But Oncologist reading of latest and recent PSA of 12.7 suggest Brachytherapy was option if PSA was 10 or below… I wonder why if tumour is still local?
Thanks to Richard reply I learned cyberknife advantage over traditional radiation is much shorter treatment time…I will be meeting Oncologist for first face to face last planning session next week and will ask the comparison of 20 treatment he has mentioned over the phone vs cyberknife..also if they have proper equipment in their facility to do this..
I guess I’m in that stage of being torn between rushing into treatment or taking time to examine treatment type, pros and cons also the fear of taking more time will put me in longer waiting list as post Covid schedule I assume has to deal with lots if backlogs.
I also still working and examining if I need a short term disability leave or not..
So for your inputs being very helpful for me to ask right questions.. and I’ll pay it forward with my experiences going through this.. any other comments from other members of this community appreciated.
Thank you allHi
. Glad the information has been helpful. I can't say why your doctor has ruled out the brachytherapy. As noted in this page from the American Cancer Society, it is generally for those in early stage PCa or combined with external radiation if more advanced: https://www.cancer.org/cancer/prostate-cancer/treating/radiation-therapy.html#:~:text=Brachytherapy%20alone%20is%20generally%20used,cancer%20growing%20outside%20the%20prostate.. You will have to ask your doctor why a Gleason 3+4, even with your PSA would be excluded. I also hope you get to discuss Cyberknife and maybe proton therapy. Look forward to hearing more information and I'm sure your ongoing story will be helpful to others. Best, Richard (ProstateCancer.net Team)
I’ve learned today the radiation therapy I will be going through called VMAT ( Volumetric Modulated Arc Therapy) which apparently is more precise than IMRT.
I’ve asked about cyberknife and apparently the center in my region they have the equipment but they don’t do cyberknife for prostate.
So next week having my first planning session and hopefully learn more about VMAT.Hi
. I did a little searching and found this study comparing the VMAT and Cyberknife: https://ro-journal.biomedcentral.com/articles/10.1186/s13014-019-1404-z#:~:text=Cyberknife%20plans%20achieved%20an%20average,4.3%20Gy%20for%20Cyberknife%20plans. Short answer is that they both did well and, while different, are pretty comparable. Other things I've seen, including from places like the Cleveland Clinic, have been positive. Wishing you the best and look forward to hearing how it goes. Richard (ProstateCancer.net Team)
