Had a TRUS biopsy at the end of September. Left Base 4+3=7,percentage of pattern 4: 50-75% Tumor involves 17% of overall specimen (1 of 2 cores). Perineural invasion is identified. Left mid, 3+3=6, Tumor involves 6% of overall specimen (1 of 2 cores). Most affected core is involved by tumor over 15% of its length.
DICIPHER from biopsy was .84. PSMA PET shows PC confined to prostate and only on left side.
Plan is 5 fractions of SBRT with focal boost (FLAME) and urethral sparing, prophylactic Flomax. Orgovyx for 6 months.
Yesterday I had a rectal spacer (Barrigel) and fiducials placed under general anesthesia. NPO from mid-night, enema at the hospital. A little “hung over” from the drugs today, but the worst part was no coffee or breakfast yesterday morning. I have no pain or discomfort from the procedure and I am taking the Dr. at his word that he did something 😊 ! My TRUS biopsy was worse than this….and that wasn’t all that bad.
MRI and CT planning next week. I will get the SBRT schedule at that time and expect to start the last week of November.
More as my battle continues.
Stay strong, F#ck cancer.
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ToolBeltZia
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I hadn't heard of the Barrigel spacer; one 'always' reads about Space-OAR. When I looked this up, it seems that Barrigel may be an improvement.
I had SBRT ten years ago; those spacers didn't exist then, but my rad oncologist told me recently that he now uses them. I wonder what FLAME is all about.
FLAME is fairly new where they irradiate the whole prostate with +/- 36.25 grays and boost the area of the tumor to 40 or 45. They also "turn it down* a bit around the urethra.I had not heard about Barrigel either, but as you said it seems to be an improvement.
How did you (short term) and how are you doing with after effects of your SBRT.
Thanks for that info on FLAME. I don't know if this is something really new or just a name for what was done anyway. Typically, prior to SBRT, there's a group meeting of the physician(s) with a radiation physicist to develop a radiation plan. Many factors are considered, but I don't know the specifics.
My own experience as a Gleason 9 patient has been positive. I had' triple' therapy (18-month ADT+SBRT+IMRT) ten years ago and even though there were some side effects (to be expected) after a year or so, I am super fortunate to have been able to live a 'normal' life. My current PSA is 1 ng/mL (and has never been over 2 since treatment). I did see a bounce at one time, but it went away.
The rad oncologist who was in charge had a lot of experience; by now well over 1000 cases (and many academic papers).
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Just getting started
Treatment Options
Advice - Surgery or Radiation?
Diagnosed 4+3
Likelihood of post-RP radiation? 
