M59, Gleason 4+3 (second opinion confirmed by Jonathan Epstein at John Hopkins), PSA7.8 average past 1 year, T2C stage. Haven't been operated or radiated before.
Currently am being offered:
1) 5 fraction Cyberknife (SBRT) therapy that is concentrated to the prostate.
2) 1 time high dose rate Bracytherapy combined with 5 week EBRT radiation therapy.
None of docs believe ADT is necessary as of now.
I can't make the choice.
On one hand, SBRT efficacy is often compared with level of Bracyhtherapy.
It is apparently very similar in results, but I'm worried if Brachy+EBRT won't be way more effective ensuring that pelvic lymph nodes are also captured in the beam?
After all my case has a rather high recurrence rate after Radical Prostatectomy according to nonograms, however if lymph nodes are radiated, doesn't that lower the risk dramatically?
And how can Cyberknife compared in efficacy when it radiates only the prostate?
There are some talks that SBRT high dose radiation is more effective in killing cancer, but it can't kill mets outside prosate, can it now? While EBRT can.
Cyberknife would be ideal solution and its close to home. Brachy+EBRT requires 5 week living in another country.
What do you think, which case would you choose in my situation?
Pros and cons of each?
What do you think of met risks with Cyberknife?