ADT + SBRT + IMRT treatment for Unfavorable Intermediate Risk PCa

[jimalong51]

Tall_Allen,

This is a follow up to a previous threat I started regarding my path to treatment. I followed your prompt to talk to Dr. Gottschalk at UCSF, and I’m glad I did. Our conversation did change things. He recommends SBRT/IMRT & 4 months ADT! He will do SBRT, and IMRT will be done by Dr. Valicenti @ UC Davis (closer to where I live). He also felt a shorter course of ADT was in order in my case. He does want to wait for the results from my PSMA-PET test, still on for 5/7, and my Decipher results on 5/12.

He doesn’t think either test result will alter his recommended treatment, but he is open to waiting. Needless to say I feel confident my choice of treatment.

Anyone else can check my bio for details on my recent biopsy. I will be posting updates as treatment goes forward.

[judg69]

Basically very similar treatment to what I had for my own Unfavorable Intermediate Risk 2 years ago, although I had 6 months ADT ( Firmagon ) . All went well, and wishing all the best for you as well, judg69

[jimalong51 in reply to judg69]

Thanks, judg69. I’m hopeful for similar results.

[Tall_Allen]

I know that Gottschalk does an SBRT boost therapy (IMRT to a wider area with an SBRT boost to the prostate). Others do an SBRT monotherapy. I doubt that there is much difference if the dose is sufficient. I guess the PET scan can rule out treatment if occult metastases are found, although that is unlikely. I don't see what difference Decipher can possibly make - perhaps longer ADT if it is high risk. I'm glad you found someone to do it locally.

[jimalong51]

Update: Completed my last session of IMRT on 9/22. It’s been a little over a week and I can report that my digestive system has rebounded and I can eat pretty much as I did before treatment began (4 months ADT; 2 fractions SBRT 8/12-13; 5 weeks - 25 sessions IMRT). I will have my first post treatment appointment, with PSA, in 3 months. I still have the 2-2.5-3 hour urination urges that disrupt my sleep, but I can’t complain. Glad that part of my treatment is over. Discovering my new normal as time passes. My mission now is to regain as much strength and muscle mass as possible. Will update after my next appointment and tests. Very grateful to Dr. Gottschalk (SBRT) and Dr. Valicenti (IMRT) and their teams for my care.