Good outcomes and experience with Eastern US SBRT, LDR, HDR centers?

[cdj70]

Thank you for this forum and to all of you that are willing to share and post your journey down this road we’re all traveling together!

51yo in Charlotte, NC. PSA 6.0 drove MRI PIRADS 4 of 1 lesion then Fusion biopsy 16 cores (4 ROI + 12 template). Hopkins 2nd opinion path shows 4 ROI cores all with 3+4 with 20% GLS4 as highest and 2 of12 other template cores 3+3 and PNI. DECIPHER score 0.21 = Low. Repeat MRI at Duke 6 months after last one confirms PIRADS 4 of 1 lesion <1cm capsular abutment but no ECE and Prostate Volume 40mL. Latest PSA 5 months after biopsy now 7.4.

Duke mulitdisciplinary visit recommending RP, but I’m not comfortable with QOL outcomes and most everyone I know that has had RP has also needed f/up RT so I am leaning toward keeping anatomy intact and doing RT.

I’m willing to travel for treatment and thank you for any advice you might have for me and my situation.

[NYC_talker]

Happy to help. Please see my posts on LDR at MSKCC in New York, and others here who did SBRT at MSK as well as those who did HDR at MSK. Good luck in deciding on a treatment -- you're in the right direction IMHO.

[Tall_Allen]

Bridget Koontz at Duke. I'm not big on multidisciplinary meetings.

[TylexGP]

Take a look at my bio. I did HDR Brachytherapy followed by EBRT at MSKCC; also was on ADT plus Zytiga prior to RT. I chose RT because I had a suspect node and the Urologist told me if you need RT post RP that any incontinence issues would likely remain where they were at the time of RT. I looked at RP and may have gone that route if it was contained to my prostate.

[Scooter22]

Pirad 5 lesion, ECE, PI, Intermediate unfavorable. I had 5 sbrt treatments in Nov. @ Duke w/fiducials & Spaceoar. Started Orgovyx adt 4 wks. B4 radiation & am scheduled for 18 mos. of the adt.. Everything has been virtually painless & professional at Duke. Of course, I have no other experiences to compare but so far I can’t imagine the process going much smoother anywhere else. Now it’s a watch & wait game just like everyone else. 🙏

[Odnad]

UNC REX just opened a new cancer center in Raleigh and UNC Chapel Hill has a cancer center and does cyberknife just not sure if they do it for PC. You already know about Duke.

[CarverD]

I was treated with HDRBT as a mono therapy about 18 months ago. So far all good. Worse part of the whole thing was pulling my own catheter the Friday morning after each of the two Thursday treatments. Side effects are minimal to nonexistent.

[Hidden]

I am same as Scooter: 6 mos. Orgovyx ( started 2 mos. before SBRT @ Dana Farber ). Smooth sailing, almost no SEs. Eas an interesting experience. Now we just get on with life and monitor. Quality of life is high :D.

[jimalong51]

Talk to Dr. Gottschalk at UCSF.

[Darryl Partner]

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[cdj70]

Thank you all for your responses. I’m currently still investigating brachytherapy options due to balance of efficacy and hopefully reduced risk of secondary cancers since 3 grandparents lived into their 90s.