SBRT in Miami

[Florida7800]

70 years old, Gleason 7 (3+4) in 1 core, 10% grade 4. Another core Gleason 6 (3+3) and 1 core with high grade PIN. This was a fusion biopsy, but interestingly, the targeted lesions from MRI turned out as benign. So the positive biopsied lesions were from random sticks.

Surgical oncologist at UM recommends HIFU in agreement with a second opinion surgeon at MSK. My concern is since two positive lesions were not detectable on MRI, perhaps focal therapy would miss other tiny lesions elsewhere in the prostate. I don’t believe they doctors do whole gland ablation.

I’m considering SBRT at MSK, have done a telemedicine visit with one of their RO’s. But since I live in Miami, wondering if anyone has had favorable outcomes at Sylvester with SBRT. I have a first time appointment with a RO next month at Sylvester for 2nd opinion. It would be easier to have RT in Miami as opposed to NYC, but I want the best I can find. There’s also an independent Cyberknife in South Miami--another possibility but I’ve been told it’s best to seek NCI centers of excellence.

[Tall_Allen]

HIFU doesn't work- even whole gland ablation doesn't work.

prostatecancer.news/2021/03...

I'm sure SBRT at Sylvester would be fine. Here are some questions to ask:

prostatecancer.news/2017/12...

[allshallbewell]

Have you considered active surveillance - including a commitment to nutrition, exercise and overall wellness? Did your doctors even talk with you about this option?

[Florida7800]

Thank you for your replies.

[Oatmeal2]

I can only speak for the care my husband has had at MSK. It is top notch. They have the best doctors, nurses, technicians and overall staff plus all of the latest equipment.

[Florida7800 in reply to Oatmeal2]

MSK certainly has the reputation. Though it would mean three trips to NYC from Miami: fiducials, another for simulation, and then the third for the 5 days of radiation over a 10 day period. If I thought UM were same as MSK in outcomes, I’d stay in Miami. Will continue to do research. Most likely will go to MSK but would love to hear from those who have had SBRT at UM Sylvester.

[Oatmeal2]

It may be possible to cut down the number of trips to two trips doing the fiducials and simulation in the same trip. Maybe they could schedule the fiducials on Monday and the simulation on Friday?

I know there is usually a wait in between procedures, but I don’t think it has to be a long time. I know some of the hotels in the area give special rates if you are a patient of MSK. The Helmsley Medical tower is right across the street and they offer little apartments plus are exempt from hotel tax which I think adds something like 18% to the bill.

[Florida7800 in reply to Oatmeal2]

Thank you oatmeal. I will inquire about both of your suggestions.

[Latenighttracker]

Just had both fiducials and simulation pre SBRT in 1 day done at MSK. It is very doable. They were sensitive about patient travel issues as they arranged it. Also the comment about the Helmsley medical tower is correct, it is right there, 1-2 blocks away depending on the procedure.

[T911]

Miami Cancer Institute at Baptist Health is an MSK alliance member. I was very happy with them.baptisthealth.net/services/...

[Florida7450 in reply to T911]

T911, thank you for that link. When I called MCI at Baptist, I spoke to a patient coordinator and was told MCI does not offer cyberknife for PC. They only offer proton therapy. Was I informed incorrectly? For that reason, I didn’t make an appointment with a radiation oncologist there. I’ll try calling back again next week, hopefully will get a different patient coordinator’s input on this. I think I accidentally created two accounts, with two usernames Florida7800 and Florida7450

[T911 in reply to Florida7450]

You were informed incorrectly. I was offered a choice of several radiation types there. That is one of the reasons I went there in the first place because they have everything and are not biased towards just what they have available. I was very happy with Dr Weiss and the whole team and facility.