IMRT CONDENSED -4 Months ADT VS SBRT -4 Months ADT

[JWS13]

The finding of the ECE after review by MSK increased my cancer to higher risk by my RO's. They are split , one recommending IMRT with 4 months rather than SBRT alone. The other recommending SBRT with 4 months ADT.

RO says their is more long term data with IMRT Condensed (20 treatments) than SBRT ... Other RO says get it over with in 5!

1. Anyone take IMRT Condensed , (20 ) visits vs. SBRT ? How and why did you come to that decision?

Secondly, Anyone on ORGOVYX for 4 months , how bad was the side effects...did you work out a lot to relieve some of the side effects ? (which were the main side effects that you got ?)

Age 68 Gleason 7 ( 4-3) with EPE, PSA 6.1

As always all thoughts and recommendations are welcome. This group has been terrific!

Tall Allen (as always) would really appreciate your thoughts???

[Tall_Allen]

I don't really see that it is a question. Why would you want more treatments when you can have fewer?

[JWS13 in reply to Tall_Allen]

They say the "data" is better with IMRT...(I absolutely don't want more sessions!!) . Ther is no long term data with SBRT and ADT and the trials don't show how the synergy would work with both treatments (sbrt &adt) or wouldn't work..just not known yet. Imrt it is known. They say less focal radiation spread out is less possibility of side effects as well. (If Sbrt is substantially better in killing C cells and less toxic short & LONG TERM ...then it's a no brainer..but their argument is "might be" but NO DATA!..

[Tall_Allen in reply to JWS13]

I don't know who "they" that you keep mentioning is. There is quite a bit of data on SBRT. All data show it is equivalent to IMRT:

prostatecancer.news/2019/02...

There will always be more and longer term data on older outmoded technologies than newer better technologies. No one uses an IBM Univac computer anymore.

[JWS13 in reply to Tall_Allen]

TA ...I have a very concerned and integral question for you , I will post later but I need your answer as I am meeting with Kishan..." If I give ORGYVYX/regulolix a real shot for 4-6 months and the cardiac symptoms particularly don't allow me to go further than a couple of weeks...What is the percentage of chance of failure with SBRT and 4 month hormone and what does it increase to with SBRT or IMRT with NO HORMONE treatment? (would you have data on exactly this?) (Is there any difference of failure rate between SBRT W/O Hormone and IMRT W/O HORMONE as well? Thanks ever so much.

[Tall_Allen in reply to JWS13]

Kishan knows more about that than anyone on the planet. Ask him.

[1Ubspaine]

diagnosis similar to you. 5 treatments recommended by a RO at a teaching hospital not wanting to maximize the bill and 6 months of ADT. ADT was a pain in butt, but over it now and wanted the best outcome.

Healthcare is a business, stay away from those ROs suggesting 25-40 treatments to get paid the most at your inconvenience.