Tomo therapy for prostate instead of bone mets...

[Advo__cate]

Is this a usual therapy at this late point in the game? To radiate the prostate rather than individual bone mets? This is what the RO is suggesting.

[Tall_Allen]

Irradiating the prostate only benefits men who have very few bone mets:

pcnrv.blogspot.com/2018/09/...

There is no known benefit to treating individual bone mets. That decision has to be made weighing safety against the uncertainty of benefit.

[Advo__cate in reply to Tall_Allen]

He has way more than a few but has very little pain this past year. He was beginning to have some a couple of weeks ago but that was short lived, he's not in pain now...not even taking tylenol.

I think we were told by the MO at dx he could radiate individual bone mets if they were causing pain. The prostate wasn't even mentioned until last week.

Hmm...

[Tall_Allen in reply to Advo__cate]

I should have said, "There is no known oncological benefit to treating individual bone mets." There is certainly a benefit in preventing fractures, and if there is pain.

[Advo__cate in reply to Tall_Allen]

In your opinion why would the RO suggest radiation for the prostate at this point?

[Tall_Allen in reply to Advo__cate]

Why not email him links to the two studies on de-bulking (STAMPEDE and HORRAD) and ask him that question?

[Advo__cate in reply to Tall_Allen]

We plan to do that at my husband's appt later this afternoon.

[Tall_Allen in reply to Advo__cate]

If you can, email them in advance. You will get a better answer.

[Fairwind]

To me, it sounds like your RO is trying to improve his reimbursements without doing much to improve your mortality.. See what your MO has to say about this or perhaps a second RO....

[Advo__cate in reply to Fairwind]

Thx.

[BarronS in reply to Advo__cate]

Radiating the prostate could help with pain palliation further down the road. Many men have their prostate continue to enlarge as the disease progresses, making it very uncomfortable and painful to sit.

Just a thought.

[Advo__cate in reply to BarronS]

This is what was explained to my husband. Palliative purposes. My husband decided to go through with it as the Tomo is less likely to cause collateral damage. The RO has been through the same therapy with great success.

[Hidden]

Make sure you also consider the side effects and quality of life issues. In my opinion, the benefits would need to be clear to make this worth it.

[Advo__cate in reply to Hidden]

Exactly what we were thinking.

[riichardd]

Barron S makes a valid point. I had an enlarged and very painful prostate. 5 days of palliative radiation made a tremendous difference to my QOL. So there was good reason for having the prostate radiated. Maybe further down the road you may need it but it seems a little pointless if you have no pain at the moment and there is no evidence it prolongs life.

Just thought I would mention during the radiation treatment, I had a tremendous feeling of satisfaction that I was killing off some of the filthy disease inside of me. But that's just me though and shouldn't be taken into account when deciding your treatment options.

[Advo__cate in reply to riichardd]

Thanks. My husband is looking forward to it for palliative QoL. He had his first round yesterday.