My husband at MSK is getting his external radiation for the entire prostate with extra radiation to the pelvic nodule in October. I have requested for MRI Linac and our RO who heads the department wasn't sure if he would use it as he said he will use the GRT. I requested again at his last appointment with the nurse. She saids he will let me know. His tumor is protruding close to the rectum. If they don't agree should I go to NYU to get it with Dr. Zylinsky at NYU who was formally at MSK for the external radiation? Do patients do that?
Also the Dr. doing the Brachytherapy which is earlier will not be using the gel spacer as the nurse told us it would hinder the radiation beams and where they need to go. Has anyone else been told that? We feel we are in great hands at MSK and happy with our excellent team to date.
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SherryKahn
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They have the machine and if they are doing the IGMRT then they can do Linac. Wonder why the hesitancy? Don't want to change the whole team at MSK so wondering if my partner can get the radiation at NYU and still continue with the MSK team.
My initial thought was that a spacer made sense too. If the cancer is close to the bowel, it will be targeted with maximum dose, and spillover to bowel at great risk.
hydrogel spacing focusing on the use with prostate brachytherapy. It is clear that spacing utilized in the setting of brachytherapy, may reduce early or late gastrointestinal side effects, and does not degrade the quality of the treatment
Hydrogel spacers can be used during prostate brachytherapy, also known as internal radiation, to reduce the amount of radiation delivered to the rectum. This can help reduce rectal toxicity and allow for higher doses to the prostate to kill cancer cells. The gel can also improve bowel-related quality of life
And they don't just reduce side effects to the bowel. Hydrogel spacers also reduce urinary and sexual symptoms as reported by patients1,2. These spacers are used for most prostate cancer patients treated with external beam radiation or seed implants.
My husband traveled to NY during covid to receive MRI guided radiation from Dr Nagar at Weil Cornell. He was wonderfully caring. Dr Nagar is now Director, Genitourinary Program, Department of Radiation Oncology at MSK so if he doesn’t recommend it, there must be a reason. He responds very well to questions.
Sherry I was just going to follow up on Conerned wife comment. You are being treated at one of the best cancer treatment facilities and you on the East coast have access to other centers of excellence as well. You also have some amazing doctors and centers of excellence. That is truly a blessing.
As a former east coaster who grew up and was educated back there you are very fortunate to have those medical facilities and education opportunities.
Now for the hard part and I am sorry if this offends you. All that being said what makes you think that your request should be honored over the opinion of that doctor? Are you an expert in the field? Can you provide a scientific case why that is necessary? Science carries weight with doctors in making your request.
Without science, medical training or experience treating this cancer, you have every right to seek a second opinion and move onto another facility. However you maybe just kicking the proverbial can down the road for no reason.
Agree with you regarding the excellence SOC at MSK and that only experts in the field should be making decisions regarding my partners health. It was a leading oncologist who suggested MRI LINAC should be used and suggested I request it. I always defer to the experts in the field. So which was the reason I was asking. Not making a decision either way just putting it out there.
Maybe the real solution is for you to have your leading oncologist contact the doctor at MSK to discuss this with him since he considered it to be a critical issue in the treatment plan and raised it with you. At least at that level - doctor to doctor it would get a hearing.
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We are Going to Ft. Lauderdale 
Intro
Wait time for radiation is 6-8 weeks in BC Canada; will this cause an issue with triplet approach?
Update on recent consult with MSK docs , comments , suggestions welcome
