It seems like a few members of this board are going through SBRT treatment at Memorial Sloan Kettering (MSK) right now. I just finished my five day course of SBRT treatment there today, and thought I'd share my experience as well in case it's helpful to anyone going through it or considering it.
My experience with MSK was overwhelmingly positive and I feel fortunate to have such easy access to it in New York. I had HDR brachytherapy a month ago, which went very smoothly, and the SBRT treatment over the past week. (No ADT in my case.0
The SBRT treatment itself has been easy. MSK handles a lot of patients every day so there can be a wait for your turn on the table, but the whole treatment itself lasts about 25 minutes. You check in, drink a cup of water (to make sure your bladder is full during the treatment) and wait to be called into the treatment room. They snap you in the mold, the VARIAN machine starts its rotations, and the process is painless and quick. The hardest part is waiting to pee once you're done!
You do have to self-administer an enema every day before you go in... frankly, I found that was the most unpleasant part of the whole process. I saw some people on this board asking whether you could go to work before or after treatment... I wouldn't advise it. End to end, the whole thing can take 3-4 hours every day, and there can be delays, so I took the week off from work. (If you're not going to take time off for cancer treatment, when would you take time off?)
In terms of side effects, on the whole they've been negligible. My urination has been fine (taking Flomax every night)... no burning or irritation. I felt a bit of leakage one day, but it went away. No other concerns.
In terms of rectal irritation, I had some mucous leakage on day 4, but that also went away. I'm taking Metamucil every morning and evening, and have had no other GI issues.
In terms of sexual function, between the brachytherapy and the SBRT, I am definitely noticing that my erections are not as hard as they were a few months ago, but I can still easily maintain an erection. I'm taking 5mg Cialis every night, and still able to have sex without any problem. My ejaculate is next to nothing at this point, but all things considered, I feel I'm doing ok.
The biggest side effect has been fatigue, which varies day to day. I'm making sure to get out for a long walk or two every day. I wish I could get back on a bike, but have been told to avoid that for another month. Getting out and moving around definitely helps keep the fatigue at bay.
At our follow up appointment today, the doctor said the odds were 90% that this was "cured." He expects my PSA to drop over the next year to below 1, and ideally closer to zero. He and the oncology nurse said the short term side effects should start to dissipate after two weeks.
I'm very encouraged by how all this has gone, and wishing luck to everyone else going through this. I would definitely recommend both HDR brachytherapy and SBRT as a course of treatment, and MSKCC has made the whole process as easy as anyone could hope for.
I also want to say this bulletin board has been a fantastic resource... thank you to everyone who has shared their experiences... I hope sharing mine might help others as they go through this.