6 months after MRI Guided SBRT at MSK

[rosenjpj]

After a year and a half of Active Surveillance, my cancer progressed to GL 4+3 and I decided to have MRI Guided SBRT in August at Memorial Sloan Kettering in NYC under the care of Dr. Sean McBride.

I had 5 sessions over 10 days and each lasted about an hour. The entire team at MSK was wonderful and they made the experience as easy and comfortable as possible.

The radiation procedure itself was painless. I experienced some urinary pain and frequency following the second session and these side effects lasted about a week after I was done the treatments. Tamsulosin helped ease the urinary symptoms.

I also took Orgovyx for four months starting a month before the radiation. As expected, I experienced loss of libido, ED, and minor hot flashes. I worked with Dr. John Mulhall and his sexual health staff at MSK to help with recovery from the ADT induced ED. The penile rehab included injections to maintain blood flow, stretch and oxygen. It was daunting at first but I am glad I was proactive. My testosterone recovery was pretty rapid and the ADT symptoms started to clear about a month after I finished my last pill.

I had my post-treatment labwork two weeks ago which was six months after radiation treatments and four months following the end of ADT. My PSA was .33 (down from a peak of 7.5) and testosterone was 513. The Doctor was very pleased with these results. Per Dr. McBride, since I still have a prostate, a low (but not undetectable) level of PSA is common and acceptable at this stage. He said he would be happy if my PSA stayed at .33 going forward. I will have my next labs in August.

I am pleased with the results of my treatment and I am thankful for the best in class care at MSK and the support from Tall Allen and my friends here Malecare/Healthunlocked.

[Tall_Allen]

Sean McBride is one of the best and Mulhall is a legend - you had a great team!

[maley2711 in reply to Tall_Allen]

How does a patient know if any certain Doc is one of best?

[rosenjpj in reply to maley2711]

Do research and check with experts like TA.

[Tall_Allen in reply to maley2711]

Read this: prostatecancer.news/2017/12...

What is best for me, may not be what is best for you. Other than local specialists, who I have met personally, I read their studies in prestigious peer-reviewed journals, and sometimes communicate with them. I look for doctors on the leading edge of their field. Their publications usually get a lot of citations in Google Scholar and they get published in journals with high Impact Factors. But not all great doctors do a lot of research, although they follow it closely. When I meet with them, they engage in meaty discussions and it is sometimes a learning experience for me. They are able to personalize treatment and not just blindly follow guidelines. They are excited by the work they do and doing the best for the patient.

I had a recent interesting experience with an RO. He was proposing a plan that I knew wouldn't work for my friend. I said, what about XYZ? He responded that my friend's insurance wouldn't cover it. I then asked him if insurance were not a barrier, what would he recommend? He then provided an excellent plan. We changed my friend's insurance.

[maley2711 in reply to Tall_Allen]

Thanks TA. Yes, makes sense. But for most of something like 200k Newly diagnosed men each year, I don't think that may be practical.

Most are going to face the challenge of selecting from a relatively small group of Docs in the local area......and many don't have the selection available in a few major cities with highly credentialed Docs and recognized PCa specialists. Thanks for that link, and I'll read the article!!! There are 2-3 other groups of ROs here, in addition to our Kaiser Docs> I now know/haave met one older guy at Kaiser, and have no idea if any from any of the other groups would be superior......I would need to pay big $$$ to consult with any others, or leave Kaiser and the benefits it DOES offer and enroll in Part B and hope I find someone any better at any of those other groups.. with recent PSMA PET still negative for my Gleason 4+5 diagnose 2+ years ago....Psa has risen from 8 to 12, prostae SUVMax from 8 to 12...I still qualify for ADT(yuck) and hypo IMRT at Kaiser....they do little if any brachy is my understanding.....haven't asked about focal boost to PIRADS 5 lesion in anterior/transition zone? Would do WPRT.....I guess some ptential benefit, but more SEs potential of course.

Thanks again...the saga continues.

[Tall_Allen in reply to maley2711]

You asked, "How does a patient know if any certain Doc is one of best?" I told you how. If you can't get to one, and you're unwilling or unable to access one of the best, you can't. One should only worry about decisions that are within one's control.

[Tierboss in reply to Tall_Allen]

Tall_Allen which you consider UCI in California a center of excellence.

[Tall_Allen in reply to Tierboss]

Yes! And I'm impressed by the doctors they've hired at COH Irvine too.

[Tierboss in reply to Tall_Allen]

thank you

[maley2711]

Just a small point I believe. The 4 might have been there from the start....but missed on 1st biopsy. who knows?

[Mgtd]

Great results. Another success story!

[j-o-h-n]

Great news.......... you're being treated at a great Ca hospital (MSK)...........Keep the lights on!!!

Good Luck, Good Health and Good Humor.

j-o-h-n

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

Thanks so much John!!!