SBRT , successes , side effects

[Keeper70]

An update to our RO visit yesterday, we met with the radiology oncologist to review the PSMA Pet scan and talked about external radiation but kind of pooh-poohed the SBRT asking my husband do you want a hole in your rectum? He seemed to suggest he start Zytiga and see how it goes for now! PSA still low at .20

My husband does have the option to get radiation now or to wait, Prostate biopsy coming soon may give more information, is it risky to wait and not treat with radiation now? We need some information please from someone who has had SBRT and how it went for you, thanks so much

[6357axbz]

many here have had very successful sbrt. Sounds like your RO is lacking in skills

[NotAlwaysSunshine]

Zero issues with SBRT and space oar.

[Keeper70 in reply to NotAlwaysSunshine]

that is good to hear 👍RO has 27 years of experience, we may find one in AZ this winter

[Andy1569 in reply to Keeper70]

I finished 44 treatments this last summer (check my Bio). I like my RO and his team very much. His clinic is in mid-north Scottsdale Az. Please let me know if you would like his info. Andy

Fight On!

[Keeper70 in reply to Andy1569]

hi Andy1569

Yes please! It’s always helpful to get recommendations from others on this forum, thank you

[Andy1569 in reply to Keeper70]

Dr Kurt Wharton / Palo Verde Cancer Center

[Keeper70 in reply to Andy1569]

thank you!! Will check him out when we r in AZ

[tango65]

You should consult with other RO.

[Keeper70 in reply to tango65]

He’s one of those straight shooters tells it like it is which we appreciate but it’s was our first time meeting with an RO, 27 yrs experience, ya think he’d be more open to SBRT

[Tall_Allen]

If he has had more than 3 bone metastases, there is no benefit in having SBRT or any other kind of radiation to his prostate. Why put him through any side effects if there is no benefit?

prostatecancer.news/2018/09...

[Keeper70 in reply to Tall_Allen]

Hi TA , thank you for sharing that. As far i remember, 3 bone Mets , several LN, but they called him oligo. My husband does not want radiation, want to see how adt+zytiga/ Pred works for now

Is that reasonable? Tia

[Tall_Allen in reply to Keeper70]

He can have both. With 3 distant metastases on a bone scan/CT, he can still benefit from prostate radiation.

[Seasid in reply to Keeper70]

There is a chance that your husband is still curable if he is oligometastatic. Radiation could kill the cancer and he could be cured. Don't miss that opportunity. Your RO in a centre of excellence could give you the best advice.

István

[spw1]

Is Lu177 not an option instead of SBRT to a met or two?

[cesces in reply to spw1]

Lu177 is not something you want to start with. It has serious potential side effects.

There is a reason they limit total number of treatments.

[spw1 in reply to cesces]

I did not know that it was not supposed to be used early on. We were at a research hospital and they were doing trials for Lu177 with early disease (something that disqualifies my husband who has mets in several spots).

[cesces in reply to spw1]

When you have a hammer everything looks like a nail.

[Seasid in reply to cesces]

In a clinical trial setting they would use 6 Lutetium 177 PSMA infusions just to "kill" a 17?mm (I can't recall) or so PSMA positive lymph node and call him "high" volume cancer.

Unbelievable, but true.

[Seasid in reply to spw1]

If you have 2 bone Mets the sbrt is the best way to kill the cancer.

The problem in using lutetium is that it can be very toxic if you are low volume cancer. That is why we should consult top oncologists.

[PCASURVIVOR]

I had SBRT on MRILinac 6 months ago, RO put in spacebar. I have had no urinary or rectal issues. Get a different RO at a Center of Excellence.

[Keeper70 in reply to PCASURVIVOR]

thank you for sharing that! We head to Az for the winter, might have to consult another RO for second opinion

[EdBar]

I had IMRT 8 years ago, I’m G9 and had mets throughout my skeleton and in several nodes. My RO radiated my prostate (debulked) and got as many nodes as he could. I had the same type of comments from my urologist about harming my intestines etc. my RO was skillful and excellent and I had had no issues from it. I also have been on ADT since dx, Lupron, Xtandi and Avodart. My PSA went to undetectable and stayed there for 6 years or so. Last year it became detectable again although still very low. I’m getting a PSMA scan later this month and the plan is to use SBRT again depending on what the scan shows, that game plan is per my MO, doctor Sartor.

Ed

[Seasid in reply to EdBar]

Good plan

[Seasid in reply to EdBar]

The urologists know that if you kill the cancer in your prostate and in the surrounding Mets than you will probably not need his service down the road. You will not need to use the catheter as a result of no cancer in your prostate.

TA also said that you could potentially prevent urological issues with radiation therapy to the prostate.

I had the very precise SBRT of my prostate with 1mm accuracy guided with MRI in real time. I don't expect to have big problems. I hope that I will not need a urologists after that radiology treatment.

István

[cesces]

Take the time to get multiple second opinions and then make the right decision.

Measure three times. Cut once.

[j-o-h-n]

BTW where are you located?

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 03/22/2023 3:29 PM DST

[Keeper70 in reply to j-o-h-n]

snow birds from MN, staying in San Tan Valley