5 weeks IMRT with Brachy boost vs 8 IMRT - Advanced Prostate...

Advanced Prostate Cancer

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5 weeks IMRT with Brachy boost vs 8 IMRT

Longterm101 profile image
20 Replies

I recently met a RO that suggested 5 weeks vs 8

Treat all lymph nodes and prostate with an additional Brachy boost

I’ve always heard 8 week treatment - anyone have 5 week treatment with HDR brachyboost

Foxchase in Philly

Gleason 9

Stage 4

Positive seminal vesicle

Thoughts ?

Thx

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Longterm101 profile image
Longterm101
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20 Replies
cesanon profile image
cesanon

I would treat the lymph nodes separately.

And for them I would use either fewer rounds of higher potency SBRT or surgery.

I had my lymph nodes treated with IMRT with a lot of treatments and it ended up killing most of my CB4 T-cells, which never grow back.

Fewer treatments of higher potency may spare those CB4 T-cells, that are elsewhere when the undergoing the treatment.

Longterm101 profile image
Longterm101 in reply to cesanon

Where were u treated ?

Longterm101 profile image
Longterm101 in reply to cesanon

Did u mean CD4 Tcells?

cesanon profile image
cesanon in reply to Longterm101

yes

Longterm101 profile image
Longterm101 in reply to cesanon

Thx

Where were you treated ?

cesanon profile image
cesanon

By the way, SBRT is more focused and higher intensity radiation with far fewer treatments.

Tall_Allen profile image
Tall_Allen

Brachy boost is never given with an 8 week IMRT schedule. Eric Horwitz knows what he's doing. Yes, of course do your pelvic lymph nodes with stage T3b and GS9

Longterm101 profile image
Longterm101 in reply to Tall_Allen

Thoughts on Cesanon comments on CD-4 T cells and using SbRT in lieu of IMRT for lymph nodes

in reply to Tall_Allen

Never is a big word. My primary treatment in April 2003, for a Gleason 4+3 and PSA of 6.8 was 118 Palladium seeds and six weeks later 25 sessions of IMRT. Planned from the get go. Back before the term Brachytherapy boost was coined.

Gourd Dancer

Tall_Allen profile image
Tall_Allen in reply to

25 sessions (5 weeks) of IMRT is standard. It is NEVER given with an 8-week course. The term has been around since the 1980s - it is one of the oldest radiation therapies.

in reply to Tall_Allen

Thanks for the information. Just never heard the term until several years ago. Lol. I marked number of sessions and not number of weeks.

GD

Longterm101 profile image
Longterm101 in reply to

How did u handle the seed implants? Side effects ? Where did u have it done. I’m considering. Thx

in reply to Longterm101

Side effects were manageable. There is trauma and swelling. Must use a condom first six weeks in case you pass a seed. Cleared for sex the same night as the procedure..... Flomax twice a day is in order, but your RO can explain. You will be given an instruction sheet...... Important, best advice that I received...... take hot sitz baths and pee away. I took four or five a day initially. If you don’t urinate, you will end up in the ER to get catheterized. Don’t mind the blood clots when you pee. You will pass them, so expect and don’t panic. Lol.

My guy was Bradley Prestridge in San Antonio..... why San Antonio? High percentage of military retirees which translates to a lot of procedures. In 2004, he had done over 2500. Your RO will have his own Urologist to assist with the procedure. Brad has since moved to the Washington, DC area.

Would I do it again? You bet. Best wishes....

GD

Tall_Allen profile image
Tall_Allen

Same question I always ask - what's the clinical evidence for departing from the standard of care? - anyone can say anything they want and there's probably a mouse study somewhere to prove any unfounded assertion. I ignore all such comments and recommend you do too.

timotur profile image
timotur

Five weeks sounds right. I'm doing HDR Brachy + 5 wks EBRT (41Gy) along with adjunctive triple-ADT for Stg 3b G7 +SV N1 M0.

Longterm101 profile image
Longterm101 in reply to timotur

Thx

Where r u being treated ?

Longterm101 profile image
Longterm101 in reply to timotur

Where r u being treated ?

timotur profile image
timotur in reply to Longterm101

UCLA, Dr Chang. HDR in a few weeks.

TEBozo profile image
TEBozo

University of Texas Southwestern medical school has a radiation on cologist that came from Mayo clinic and promotes the boost. Apparently that's where it came from.

Jplew profile image
Jplew

Had my SBRT at Methodist Hospital in Indy. Dr. Ishaq was fantastic. Three radiation treatments one week and two the next. He put me on Argovyx in May and I had the treatments in June and July. Only side effects have been hot flashes! Wish you the best.

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