SBRT or HDR Brachytherapy - 48 y/o
I’m 48 years old and diagnosed with the beginning stages of intermediate prostate cancer. Highest Gleason 7, in 4 areas, highest PSA was 7.1. Was mostly 3-5.5 during active surveillance. I’ve definitely ruled out surgery, and my options for radiation are SBRT or HDR brachytherapy. I’m fit, very active and monitor my body closely and like to think I’m in tune and to know it very well.
While my Dr. feels confident with both curing it, he mentioned with my age there are more long term studies for the HDR Brach, but was not turning me against the SBRT at all and has had great success. He was an advocate for it in the early 2000s when it came out. I’m leaning towards the SBRT, and some lifestyle changes afterwards with diet, supplementation etc. (obviously continuing to exercise) while closely monitoring my PSA.
Most of his patients that go the SBRT route are older, so I did want to hop on here and check to see if any younger folks had experience with SBRT. Apologies if anything I’ve discussed is redundant in the boards, but I have been through them pretty thoroughly over the past couple of months during my ‘journey’ as they say.
I have had all the bone scans, MRI, CT etc and nothing has spread, and I’d like to keep it that way and take action soon.
Proton therapy is not available in my area, or approved by insurance yet. We have a center coming that is about 3 years out.
Thanks in advance for any input or experiences you may want to share with me!
I had SBRT a year ago. Side effects that everyone worries about, yes, but I'm sure it would have been worse with less precise radiation. My circumstances ruled out surgery ... I live alone and work alone. No help at home or work. Taking the time to recover without being able to lift or strain would not have been possible. Doing 40 days of EBRT would have driven me insane. I'm already half way there... But don't get sold on all the hype, there's some kind of damage that comes from all the treatments, SBRT included. For me it's chronic radiation proctitis, and still frequent and uncomfortable urination. I'll be on meds and supplements probably forever. I'm 55. Treated a year + ago. My biggest regret is not having been in top physical shape before undergoing treatment. It knocks the wind out of you, the stronger you are going in, the less you have to make up for later. Good luck!
I agree on the advantages of being in good shape. Prior to treatment i was riding a bike 25 miles a day - 4 days a week. I did quite well with surgery and the same some 5 years later when the "cured" cancer returned. Anything you can do to exercise and eat properly is not a bad idea in my book. Dennis (ProstateCancer.net TEAM)
Thank you for the reply sir! I’m sincerely sorry for your troubles and lingering side effects. I wouldn’t wish them upon anybody, but I guess we are willing to deal with them to try to be cured and make our best decision. I went with my gut feeling choosing the SBRT, so I’m going to do my best to prepare and hope for the best. While I’m not alone, my wife didn’t have the time to talk through my decision with me, and calls it the easy kind of cancer. So I made the decision based on my own research and gut feeling. I really do wish the best for you in the future, and I’ll report back with my progress. Best of luck to you
There is so chatter out there about prostate cancer being "the cancer men live with and die from something else" nonsense that it is easy to see why so many brush it off as non important cancer. Guess what ...it is still Cancer .
Yes ... for about 70 % of men some form of treatment can result in remission but for the other 30% it is not a similar journey. I also point out that treatment for PCa is not insignificant. Depending upon the options chosen the impacts on men either immediately or in the future can be mental, emotional and physical.
I always suggest that men and their partners get involved in some kind of education and support group for prostate cancer on line or in person . Finally by all means continue to get regular check ups and post treatment PSA testing. Dennis (ProstateCancer.net TEAM)
Maybe investigate the probability of cure for your two paths?
The magic of brachy is that since the radiation source is in the prostate, they don’t have to worry about shooting radiation through other parts. So with brachy they can give you a better dose than they can with external shots.
Go here...
https://www.prostatecancerfree.org/compare-prostate-cancer-treatments/
Learn the odds.
Also the three graphs look better on a laptop vs phone. I printed them out to study.Your wife not wanting to discuss it, and telling you it's the "Easy kind of cancer" means you are ... kind of ... doing this alone. Do it for yourself, not the kids, not family, not work, but for how you want to express gratitude for living, and for the good you'd like to do in this life. SBRT and Brachy are similar, SBRT is less invasive. Brachy means you're radioactive for a while and there's some restrictions there. Surgery means no poison, but recovery is a bummer. There's no right or wrong answer. You do the treatment that's available, and if you have options, you do the one that fits your intellectual satisfaction, emotional tolerance, budget or schedule. You then balance that by what your docs are telling you, because they really want to succeed. And you get second opinions - always! There will be consequences to whatever choice you make. The more fit you are (body and mind) the better you'll handle them.
I wish you the best.
