The roller coaster ride continues. Please pass the Prozac.
I met with radiation oncologist at Fox Chase earlier today. Like everyone I have me there he was pleasant, knowledgeable and really spent a lot of time discussing options.
Per me prior update, I have been desperately trying to avoid the surgical route as I fear becoming an incontinent, suicidal hermit with ED and a malformed tool. My own research has been holding out high hopes for SBRT, either with Spaceoar or MRI guided. Have also considered brachy but suspect my 96cc prostate along with taking bph meds makes me a poor candidate.
So, radiologist feels that:
Brachy is not a good option. The enlarged prostate makes placement of the seeds a challenge.
In terms of treating the cancer, likelihood of recurrence, radiation on par with surgery.
Spaceoar. Probably not a good option due to size of prostate.
EBRT becomes the remaining option. However, the have concerns about urinary complications with SBRT. Again, comes down to prostate size and history. That leaves traditional 8 week daily treatment. Guided conformal using Calypso markers. He seems to think this is less risky in my situation than SBRT however he still feels that there could be short and / or longer term risk of complication. Short term can likely be dealt with, longer term more if an unknown. He did not seem to think there is significant risk of urethral stricture or rectal fisures.
When my spouse inevitably asked the what would you do question he did not give a definitive answer (which I do respect). However, even I could read between the lines that he thinks I am probably a better candidate for surgery than for radiation.
It's one thing when the urologist/surgeon is telling you that surgery is your best option, quite another when RadOnc is essentially saying the same.
I have one more consult next week with multiple specialists at another, smaller, COE. For now, the cards are not falling as I might have hoped.