72 year old diagnosed with PCa in 2013. Remained on active surveillance until last year. I’m scheduled to undergo SBRT next month at UCLA Medical Center. Dr Kishan will conduct the procedure,
7/10 (60% pattern 4, grade group 3). Carcinoma present 2 of 3 cores approximately 10% of the tissue. My decipher score is 0.37, Low risk.
I’ve reviewed the side effects. What I’d like to know is what would you do differently both pre and post procedure?
Thanks. Ralph
I cant stress enough the importance of vigorous exercise. It increases oxygenation, which helps the radiation do its job, while protecting healthy tissue. I took NSAIDs to prevent inflammation - I figure it is easier to prevent inflammation than to stop it once it gets started.
Here are expected side effects:
prostatecancer.news/2018/10...
Tall, is SBRT considered a type of focal therapy? Or is it a different class?
No, it is almost always whole-gland.
Ralph, Allen is absolutely correct. Exercise, walking outdoors or indoors is really important. Eating veggies and fruits, keeping well hydrated, maintaining a positive optimism and practicing meditation and mindfulness is really helpful. Those were the things that helped me. I was on AS for almost 5 years before SBRT. My only side effect from the fractions was peeing like crazy! which subsided after 5 days. My RO gave me a prescription for AZO which was stronger than OTC. I used Cialis 2.5 mg a week prior and a month after the SBRT. This site and doing my research on SBRT and other options along with TA's insights really helped. Also speaking with friends and family was also a source of supportive care. Every person is unique. I didn't focus at all on the potential side-effects because I then have the potential to "worry" or become too "anxious" (It's why I seldom read any of the side-effects of medications or else I'd never use them! lol) I really wouldn't do anything different. It's been 5 years since my TX and I am doing great! Best to you! Joe
Agree that excercise and heart healthy diet (low fat, low carb) are the best things you can do for yourself before and after. Try to do what you can to stay centered (meditation, yoga) as well. Do your homework and join a prostate cancer support group. You are not alone and it really helps to talk with others who are going through similar challenges.
I'm meeting with Dr. Kishan this Friday for the first time. Thanks for posting your questions and thanks to everyone who's replying - it's very helpful.
I'm meeting with Dr. Reiter the following week to discuss any other options as well.
please let us know what you find that may be useful. Thanks
I was going to the gym three times a week before my diagnosis, but I really ramped up the cardio right before my first treatment. I had also been vegan for many years before my diagnosis. During treatment, I didn't hit the gym, but I walked about two miles a day.
Right after treatment, I was prescribed low-dose sildenafil. At this point -- 3.5 years since treatment -- I don't know if it is making a difference, but I still take it as some type of "psychological security blanket."
12 years on AS sounds like a real victory. I hope you dont mind me asking, what changed to prompt your move to SBRT at this time? Wishing you the best of luck.
Not certain if the question was directed at me but I had 7/10 (60% pattern 4, grade group 3). Carcinoma present 2 of 3 cores approximately 10% of the tissue. My decipher score was 0.37, Low risk. I wasn’t confident to remain on AS. I chose SBRT based on studies. I chose UCLA Medical because of their track record and preciseness of treatment. SBRT very precisely targets radiation to the tumor while minimizing exposure to normal tissue, allowing for the delivery of a much higher radiation dose and without risk of postoperative complications and mortality.
Yes, I was asking you, thanks. Were those numbers much worse than while you were on AS?
My PSA started increasing and MRI showed suspicious area and biopsy revealed same. PSA from 2021 to present moved from 5 to 10 in that time frame. I’ve always had higher than the standard PSA readings. Since I was closely monitoring, quarterly tests and annual MRI it was time to pull the trigger. The current biopsy didn’t show any aggressive cancer however the 4 + 3 and 60% was enough to seek treatment. I follow Dr Mark Scholz and value his opinion as others. He has a lot of videos on YouTube that are worthwhile. If you haven’t check them out.
Thanks. I agree re Dr. Scholz. Excuse me for my lack of knowledge, I'm a new member of this group so I'm not exactly sure what you mean by your numbers. You have tumors in 10% of 2 cores? and they are Gleason 4+3? after 12 years your Decipher score is 37? Is that right?
Almost. Since I was monitoring closely I was trending in the wrong direction. I had 7/10 (60% pattern 4, grade group 3). Carcinoma present 2 of 3 cores approximately 10% of the tissue. 4+3=7. My decipher score is 0.37, Low risk. From my latest biopsy. It was time for treatment in my opinion.
I also got a second opinion on my biopsy from John’s Hopkins.
SBRT in 2/2019. Favorable intermediate PC. You already have good advice from the others. I run, bike, kayak, resistance train and anything else that doesn’t hurt several times a week. I echo the use of low dose cialys before, during and after treatment. It also made a huge difference in my peeing at night and I still take it every other day. No evening peeing for a long time and no ill side effects for me. I went with the SpaceOar, which may no longer be standard of care, but I still had bowel issues, urgency and frequency, for several months that have mostly subsided. I had a small PSA bounce 3 years post treatment, but went back down and has stayed around .2 the last two years. No regrets
Thanks. Good stuff.
SBRT in Miami
Sling Procedure for Minor Incontinence 
SBRT vs EBRT
SBRT alternative
SBRT #4
