SBRT process just starting

[Info_Search_JMA]

Hello and THANK YOU to all you brave and extremely knowledgeable folks for posting your priceless experiences and expertise here and to the brave spouses and partners as well. This Network has helped keep me sane since I was diagnosed with PC in 2023 and I could not decide on which way to deal with it. My status is in my profile but I am basically "Intermediate Favorable" with two legions identified using MRI. Gleason scores of 3+3 in three samples and 3+4 in one sample out of 19 total samples taken six months ago during a "targeted" biopsy. Decipher test done and the result was 0.58 just below high risk category starting at 0.60.

My urologist suggested either RP or RT. I have decided on SBRT at Norwalk Hospital in CT after meeting with the RO there and learning about the process and options.

I had the Spacer gel and three gold fiducial seeds put in place on 3/22/2024 and I go for the simulation and scans for the SBRT procedure mapping on 4/5. I have no side effects from the gel/seed procedure except initial soreness where they went in through the perenium. I was put out for the procedure. I am taking Finasteride (propecia) to try to shrink my prostate, Tamsulosin (flomax) to urinate better and I will begin taking Tadalafil (cialis) once the radiation starts to assist the bloodflow.

I plan to post updates from my procedure and certainly post any questions I have.

Thank you all again for all your help and guidance.

My Best Wishes for the best possible outcomes for All .

[ToolBeltZia]

You got this Brother. I finished SBRT on Dec 28th, continuing with Orgovyx through May. No side effects from SBRT, minimal hot flashes at night from Orgovyx.

We are all here for each other.

Stay Strong Brother!

[Info_Search_JMA in reply to ToolBeltZia]

Thank you ToolBeltZia. I just checked some of your additional posts and your 14 day post-SBRT updates. I need to check out some of the recent links you posted. It looks like all is going very well. I am very happy for you. Stay strong and keep the great news coming! Also, I plan to ask my doc about Orgovyx since it has not been brought up yet.

[ToolBeltZia in reply to Info_Search_JMA]

Excellent. It is crucial that we advocate for ourselves.

[Info_Search_JMA in reply to ToolBeltZia]

For sure!

[LBRV711]

My last SBRT session was on 1/31. No issues. Feel great. You will be fine too. Many blessings to you for a long and healthy future.

[Info_Search_JMA in reply to LBRV711]

That is excellent news that two months out from SBRT, you feel great and all went well. I hope to follow in your footsteps and can report the same in a few months from now. Stay healthy and safe!

[Seasid]

Everything sounds great. Which hospital are you using for all of this?

[Seasid in reply to Seasid]

Why don't you take Avodart?

[Info_Search_JMA in reply to Seasid]

Looks like my replies jumped in order here, oops... I did not think about looking into the difference between Avodart and Finasteride. I just read something now that Finasteride may shrink the prostate a little faster but Avodart seems to shrink the prostate a little better. This is just from one internet story comparing the two. I will check with the RO who prescribed it. My best wishes for you as well!

[Info_Search_JMA in reply to Seasid]

Hello Seasid, I am going to the Whittingham Cancer Center at Norwalk Hospital in Connecticut. If I am correct, it is the only facility doing the five day SBRT in Fairfield County CT. There are other facilities within driving distance like Sloan Kettering in White Plains NY, Yale and Hartford Hospitals in CT. I met with the RO at Norwalk and felt good about going there.

[Seasid in reply to Info_Search_JMA]

My SBRT failed because I have a crpc in my prostate and SBRT is not proven yet for high grade prostate cancer. I believe it is still experimental. But for your grade 6 cancer hopefully will work well. You need a best possible RO.

[Bourbon2024]

I’m having HoLEP surgery in June then SBRT in Nov or Dec. I will have SpaceOar - not sure about fiducials - probably no where to place them??

[Info_Search_JMA in reply to Bourbon2024]

I needed to do some reading on HoLEP before I replied. I was not aware of that procedure to reduce BPH issues (and prostae size?). My MRI showed my prostate being 5.9 cm x 5.0 cm x 5.1 cm with an estimated weight of 69 grams. I was told that it was too large for brachytherapy which is done at 50 g or less. I was already favoring SBRT. No issues with my spacer or fiducials at all, done 12 days ago. I wish you all the best with your procedure and the SBRT to follow.

[UnexpectedPC in reply to Bourbon2024]

Is Holep recommended if flowmax doesn’t help? Curious as I’m on flowmax right now and I can’t say it’s working all that spectacularly

Thanks

[UnexpectedPC]

Good luck with your procedure.

I have a very very similar PCa and also decided on SBRT. I’m 49 so just a bit younger.

After meeting with a great group of doctors at Duke I’m going with SBRT with the space oar and dots being put in on 5/9/24.

I’m a bit worried about the minor surgery with the perennial part. Did you have to take any pain meds? Did it the pain go away pretty quickly?

I’m doing scans and mapping same day after the morning procedure with jel and dots so I hope it’s not too much in one day.

Please keep updating this thread. Thank you and good luck again beating this unwelcomed diagnosis.

[Info_Search_JMA in reply to UnexpectedPC]

My condolences for your father. I get why you monitored your PSA so closely during your surveillance. So they have gone through my perineum twice now. First, for the targeted biopsy and then for the spacer and fiducial markers. Both times, I was knocked out and woke up when it was done. I must say that there was not much pain after either procedure and I did not need to take any pain medication. It was more a soreness that lasted 2-3 days. I did take an antibiotic for 4 days just for infection risk. I will have the mapping done in 2 days and will update status. Best wishes and the best health outcome to you. Thank you

[janebob99]

You may want to switch to the newer drug, Dutasteride (Avodart). It has two different mechanisms of action (pathways) on reducing the 5-alpha reductase enzyme, whereas the older drug Finesteride only has one mechanism of action.

I don't have data comparing the two different drugs head-to-head Re: prostate cancer, but most of the recent data from the last 10 years primarily used Dutasteride .

One good example is a Placebo-controlled study of Low and Intermediate Risk men that measured (with an MRI) the amount that tumors shrank after 6 months when taking either Dutasteride or a Placebo. The tumors grew 17% after 6 months in the placebo group (as expected), but the tumors shrunk 31% in the Dutasteride group, for a net difference between the two of a whopping 48%! PSA dropped by 50% in the Dutasteride group (as expected), and the rest of the prostate shrank as well.

Some men don't respond to Dutasteride, however. 15-30% don't respond well, depending on their cancer stage.

I currently take Dutasteride monotherapy (no ADT), and my PSA dropped from 10.0 to 2.44 (76%) over 4 months of just taking Dutasteride. It's a real thing!

I'm scheduled to do SBRT in June, with SpacerOAR.

Let us know how you do.

Bob

Tumor Volume by MRI on Dutasteride

[Info_Search_JMA in reply to janebob99]

I will ask the RO about Dutesteride vs. Finasteride. That is some PSA drop you had in four months. My best wishes for you and I hope for the best possible outcome with your SBRT in June. I hope to have my SBRT sessions done by the end of April and I will update status here.