After 2.5 years on active surveillance with Dr. Ehdaie at Memorial Sloan Kettering, my cancer progressed to GL 4+3 (Unfavorable Intermediate Risk) and I needed definitive treatment. I opted for MRI guided SBRT with Dr. Sean McBride after getting a second opinion from Dr. Kishan at UCLA.
I started in mid-July a four month course of ADT with Orgovyx. So far I have experienced the typical side effects... mild hot flashes, loss of libido, ED and difficulty reaching orgasm. My blood sugars are rising by still under control. With Orgovyx, I'm hoping to have a faster recovery of testosterone when I stop than I would otherwise experience with Lupron and other ADT meds. I have been consistently working out with weights with the help of a trainer to offset loss of muscle mass, weight gain and fatigue.
After speaking with Dr. McBride and Dr. Kishan, I opted to have space oar placed to protect my rectum. It was an outpatient procedure conducted under anesthesia. It was painless and recovery was quick. Having a bowel movement is more difficult since there is less space between the rectum and prostate. However, Citrical, Senna and Colace help.
My first of five radiation treatments was on Monday. Each session starts with an enema but unlike other forms of radiation, MRI guided SBRT requires and empty bladder instead of a full one. The first session was about an hour with an initial 45 minute MRI followed by about 15 minutes of SBRT. It is difficult to stay absolutely still but otherwise it was painless.
The entire team at MSK is wonderful. They are tops in the field, smart, kind and very responsive. I couldn't ask for better care and recommend MSK highly. Having a world class cancer treatment center makes a huge difference.
I have four sessions remaining, including today and will keep you posted.
MRI guided Stereotactic Body Radiotherapy (SBRT) for favorable intermediate recurrence?
hernia surgery & SBRT 
SBRT 
IMRT CONDENSED -4 Months ADT VS SBRT -4 Months ADT
