SBRT treatment

[wally198562]

I was on the fence until recently about my treatment plan but I've finally decided on SBRT. 39, PSA 6.28, Gleason 3+4. Didn't want RALP because it is difficult to determine the long term side effects. Tall Allen is a huge contributor to this page and inspired me to dig deeper and I happened to find this.

cancer.gov/news-events/canc...

[pd63]

I had similar diagnosis completed SBRT last April apart from initial expected urinary discomfort that lasted a couple of weeks things quickly settled down, no issues since.Pre treatment psa at 5.2 came down to 1.6 at 6 months, next psa in April.

Best of luck

[wally198562 in reply to pd63]

That's amazing. I'm probably going to add brachytherapy or ADT to just get it over with. I'm 39 and want to have my quality of life as much as possible

[pd63 in reply to wally198562]

Being favourable intermediate is ADT necessary

[WisdomSeeking in reply to wally198562]

As per NCCN guidelines, brachytherapy boost is for risk groups "unfavorable intermediate" and riskier. See picture attached. I think SBRT alone will do in your case. ADT also has side effects and I don't think you need it.

NCCN guidelines are accessible after creating a free account at: nccn.org/professionals/phys...

To see the attached picture in detail: 1.) click on it, 2.) RightClick 3.) choose: "Open image in new tab". At least in Firefox web browser.

NCCN - RT principles

[MrGreenJeans]

I went the SBRT/ADT route. 4+3 (one sample), others 3+4, PSA 5.5, Decipher .55. Had a few consults with Brachy specialist at MSK and they didn't think it was necessary for me, even though I was interested in it since my Dad had successful treatment over 20 years ago with permanent seeds. Doc thought that SBRT alone could work, but given the higher Decipher, we added 6 months of ADT (Orgovyx). SE's from Orgovyx - no libido, hot flashes that mess a lot with my sleep and weight gain. SE's from SBRT are very minimal - taking Flomax to help with urination. Would strongly suggest losing some weight before going on ADT. I've never had an issue controlling my weight, but find it a real challenge wile on Orgovyx.

[Mgtd in reply to MrGreenJeans]

Exercise helps too with SEs.

[Cooolone]

BT has its drawbacks as does every single therapy, bar none!

Difficulty determining Long Term Side Effects!? You bet ya'... NOBODY can predict what you'll experience, period! Everybody's diagnosis is as individual as the person is, do NOT make the mistake believing that because your buddy, or because some statistics gathered across a wide spectrum of diagnosis will predict exactly how you'll respond.

The single mitigating factor that you CAN do to help receive the absolute best chance at curative therapy and reduce the possible negative post therapy experiences is to get the Best of the Best! Get yourself to a Major Cancer Center and one rated in Excellence! Don't skimp, travel if you must... But it's at the COE's you'll receive the very best in care, from diagnosis to treatment, including access to the cutting edge and trials of necessary!

Great too for your 2nd opinion or third even, before making a decision!

Good Luck!

[Teacherdude76]

One strict thing to live by: the choice you made is the best for you!NEVER second guess your choice.

There are no go back Do Overs.

Be well, Live your life: it's the only one you have - be Positive in Attitude

[GARunner1]

Hi. When I had my first biochemical recurrence after a prostatectomy and had IMRT salvage radiation, I read and was told that ADT increases the effectiveness of radiation. Maybe it is different with initial treatment with radiation or with SBRT. Maybe that is no longer conventional wisdom. Anyway, it might be helpful to discuss with your treating doctor and/or medical radiologist. Wishing you the best on this journey.

[wally198562 in reply to GARunner1]

I am going to speak about ADT and/or brachytherapy coupled with the radiation. Seems like both methods give higher overall success rates.

[CubFan]

ADT, brachy, and IMRT is really powerful combination for G3+4. That was my treatment for G8, later revised down to G4+3. I endured 6 months of Lupron. According to my RO, "we smoked it". Time will tell . . .

[wally198562 in reply to CubFan]

What im hoping for. One and done and carry on with my life

[eswann3937]

I had PSA of 4.7 and biopsy of 3+4 Gleason. I had a cryoablation. Therapy in October 2024 and three months later had PSA of 0.5.

I am doing well with no incontinence and mild ED symptoms controlled by medication.