My MSK Precise / SBRT Journey -- 2.5 Years Post-Treatment

[Hope4Happiness]

I completed SBRT treatment for Gleason 7 (3+4) PCa at MSKCC in NYC in November 2021. My PSA was 8.7 right before the treatment. My doctor: Dr. Michael Zelefsky.

Since that time:

-- My PSA as of May 2024 is 1.32.

-- I've had no real urinary issues since treatment except for some bouts of urgency especially after sitting for a while or after long car rides.

-- I've had no bowel or rectal issues.

-- Sexual function is normal and consistent (I'm still taking Sildenafil but I don't know if that has actually been a help or just a placebo because I've been on it since the treatment). Surprisingly enough, I still have some ejaculation all this time after treatment.

After being a patient at MSKCC for close to 15 years, I was notified early this year that they might not continue to accept my current insurance as "in-network." There have been quite a few contract negotiations and extensions, but it did make me uneasy as I didn't want to be caught unable to afford appointments and follow-ups. That prompted me to contact Dr. Michael Zelefsky (who has subsequently departed MSKCC) and make an appointment with him at NYU/Langone.

After reviewing my current PSA and the time since my SBRT treatment, Dr. Zelefsky recommended I undergo an MRI -- Not because there is anything outwardly suspicious, but mainly because I'm still under 60 years of age.

I just had the MRI last week, and the report revealed:

-- "No findings suspicious for prostate cancer."

-- "Peripheral zone: Decreased T2 signal likely Inflammatory."

-- "Transition zone: Enlarged and heterogeneous in appearance - consistent with BPH."

-- "No evidence of EPE."

-- "No evidence of seminal vesicle invasion. "

-- "No pathologic pelvic lymph nodes."

-- "No aggressive osseous lesion."

In addition, it appears my prostate has shrunk a bit.

Overall, I am extremely grateful for this outcome!

It's unfortunate that I must leave MSKCC -- all my experiences have been fantastic and the staff is wonderful -- but I am very happy to be under Dr. Michal Zelefsky's care again and to not think about insurance issues for the foreseeable future.

[Tall_Allen]

Great news!

[ADT-first-timer]

This is great to hear. I completed MSK Precise 4 weeks ago, and have 4 more months of ADT. Glad it worked out for you!

[mac-12]

Looking at SBRT if ever needed, now adjusting my lifestyle to arrest any growth and kill the enemy. Diagnosed gleason 3+4 60%, but dont know how much of60% is 4. 3 biopsies were 3+3 same side but small percentage 2%, 20%,50%, lesion was .9mm. Taking Dutasteride and natural testostorone blockers, sulforaphane, fasting. Gold standard is to see that lesion shrink, starving the cells of energy to kill the weakest ones(cancer), thats what chemo does, poisons cells the weakest(cancer) die. Looks like you have good outcome, I' m on AS using MRI, PET-SCANS, psa adjusted because of dutasteride, main objective block anything that feeds(testosterone,sugar,fatty, red meats, no carcinogens) I use VA, 64yr, next world much nicer, the good Lord bless.

[WilsonPickett]

Congratulations. You and I are running a parallel experience, except that I’ve gotten no such notifications from MSK. NYU Langone is the other great hospital in New York City. You’re in great hands. Especially with Zelensky. My PSA was down to .52. I’ve had a bump up to .95. We think it’s prostatitis and I’m back on Alfuzisin. Bloods again next week. Wish me luck….

[j-o-h-n]

Ask here for recommended replacement RO at MSKcc.

Good Luck, Good Health and Good Humor.

j-o-h-n

[Xavier10]

Can't hurt to have a PSMA before they exit the insurance carrier

[NYC_talker]

Great to hear, congrats! We've been on this journey, and at MSKCC, on roughly the same timeline. Happy to report all has gone in a positive direction for me as well.

[Cooolone]

SBRT as my 6th line therapy @ MSKCC in "Whack-a-Mole" treatment to 3 suspect locations. Anyways, so far, so good too!

That "Likely Inflammatory" statement is what missed my metastasis... Only found when suspected appendicitis resulted in an appendectomy which found lesions studding my Peritoneum and one on my Appendix which attached to my colon. Those scans, including PSMA were not avid and even though it was there, was poorly differentiated.

So it's good that you've done well! Zelefsky has credentials that are too notch, I'm just curious why the change if venue, let alone it's cross town so to say... And I would have no issue asking that question of the doctor should I ever need his services.

All the Best!!!