SBRT soon

[wally198562]

Stats. 39, 3+4 Gleason, PSA 6.28, diagnosed 1 May. Duke didn't want to do radiation. Flat out told me they wouldn't radiate a 39 year old prostate. Thank you for wasting 7 months of my time and billing my insurance thousands of dollars and the 2nd unnecessary biopsy. Got referred from Duke to a regional cancer center in NC. Doctor ordered updated PSA and MRI since those were last done in July/August respectively. I'll have gold markers placed on the gland or in the gland. Not too sure, and gel placed between the prostate and rectum to keep some space between them.

My question is, should I also ask for brachytherapy or ADT coupled with the SBRT? Will it help? Also, a hypothetical here, if I get a 2nd malignancy from radiation, can I then have RALP for whole gland removal?

[Tall_Allen]

For "favorable intermediate risk" there is no benefit adding brachytherapy or ADT. Unfortunately, at 39 you are an outlier for any therapy, so they would rather just be rid of you than take a chance.

[wally198562 in reply to Tall_Allen]

So, it won't help anything for an added therapy? Probably why the doctor didn't even mention it. I've read that coupled together, SBRT with ADT or brachytherapy can help overall success rates.

[Tall_Allen in reply to wally198562]

Not for favorable intermediate risk.

[wally198562 in reply to Tall_Allen]

Thank you so much. I appreciate all of your insight and guidance.

[MakeItRainbows]

My understanding is that a prostate can be removed after radiation treatment but it’s not an easy surgery. There’s maybe only a handful of surgeons that can do it. But doable. Whether/when recommended, I don’t know.

[wally198562 in reply to MakeItRainbows]

If it comes to that, I have care established already with Dr. Polascik at Duke and he's one of the best. I am confident he could do it, if it comes to that. It is a concern but I've let it go. God is in control.