Dad opted for radiation.

My dad had his appointment with the oncologist today who talked him into agreeing to radiation, 5 days a week for 7 weeks.

My dad said he wanted this over surgery and he was happy with the 95% success rate he was told.

So, in July he'll start his treatments.


I really don't know how I feel about it. I read that radiation can bring more issues with it so I am worried for him about that. And I think I read that after you take radiation treatments it leaves you inoperable to remove the prostate at a later time, am I right about this or did I misread?

Radiation is a good choice. Surgery has is share of bad side effects. Radiation as somewhat different effects that take longer to show up. Some people tolerate radiation better than surgery.

I went the radiation route and am very pleased with the result. I had a brother that did surgery and both of us ended up with about the same number of issues and two years later, we're both doing about the same.

Radiation will effectively kill the cancer in the prostate and an area around the prostate. Everyone worries about not being able to do surgery later, but frankly, if the PC is still in the prostate bed, the radiation will zap it. If the PC has escaped the prostate PC then you're on to HT and follow on surgery won't be needed.

He'll do just fine and has made a great choice.

Andrew

There is a newer kind of radiation called SBRT (sometimes known as CyberKnife) that only entails 5 treatments. Fatigue is seldom associated with it, and SEs are typically mild and transient.

It has an extremely low failure rate. If salvage should be necessary, salvage brachy or re-treatment, may be a better choice than salvage surgery.

(See link in my signature for more info)

He has made a good choice IMHO. I wish I had made that choice(it was actually nearly impossible to decide). Part of the reason I feel that way is hindsight, admittedly. But now I feel pretty sure I could have easily had statistical odds of a cure at least as good as what I ended up with( no better than 50%), maybe better. But what I did get plenty of is the surgical side effects, which were almost guaranteed. So after all is accounted for, it is hard for me to see what I have gained for all of the side effects.

Of course, You can get the side effects with radiation no doubt(I had been considering seeds/ebrt combo therapy), but I think the odds were way lower And/or at least delayed.

Good Choice. I'm sure he will do fine. I am doing my simulation and planning session tomorrow. Then will begin the 40 treatments next week.

I never really needed help getting to / from my treatments, and after I soaked the drivers seat with a couple of water torture failures, I wouldn't have wanted to put my friends through that.

My sig has a day-by-day of the process. Mine was adjuvant, after surgery, so a few less sessions.

I was sitting each day with a cycle of guys who were at different stages of RT as a primary (not adjuvant) treatment, and of those who talked often (and the wives who did even when hubby didn't), there were not any significant "aw crap, why did I do this" stories. The one RT guy who was an arse was just a bad person. The day of his last treatment, he did NOT get a diploma and picture with the girls (as all of the rest of us got). He got an AMF and finger salute as he drove away.

The "no surgery after RT" is a technically valid statement, in that doing surgery on a radiated prostate is a difficult thing done by few surgeons. But it is also a poor argument, as a properly radiated prostate is a cooked dead zone that does not need to be removed. May I suggest you ignore that argument as being of marginal significance.

I chose surgery because my potential RO suggested a success rate somewhat less than I felt was acceptable.

The difficulty in my situation was that the micro-mets were already present and widespread, so neither the surgery nor RT were winners. I was a lost cause before my first step. But that can only come from hindsight.

See my diary of RT in the thread linked in my sig.

Are you in Seattle? If so, he has some great options there that wouldn't entail so many trips. Peter Grimm is probably the foremost brachytherapist in the country, and that involves only one visit, with a prep visit and a follow-up visit. Robert Meier at Swedish Medical Center does external radiation (SBRT) in only 5 visits, with another couple of visits a week earlier to place fiducials and do the imaging. I think he would find either alternative more convenient, fewer side effects, and at least equally curative.

My dad had radiation 15 years ago for G6 and he is fine.  He is now 73.  His PSA is still <.1

I'm sorry I don't know anyone in Eugene - only in Seattle or Northern CA.

I hope a brachy guy will correct me if I'm wrong, but I think brachy (seeds) involves a visit to do the planning a few days before a visit to do the placement, and then an assurance visit a month later.

For SBRT, a local urologist can do the fiducial placement. Then a week later, they do the CT/MRI scan for planning. Then actual treatments can begin a few days after that - 5 treatments, every other day (although some do it 4 days in a row).

Either of those would mean a lot fewer doctor visits for him vs IMRT, and I've never heard of fatigue being a problem, as it may be from 40 IMRT treatments. Also, there is no downtime or recovery time during or after those treatments.

Confirming Allen's thoughts...if LDR brachy is an option then Dr. Grimm in Seattle is one of the world's best. Typically, after confirming that this is the treatment of choice, there are three brachy visits for the treatment (1) a volume and mapping study done shortly before the treatment, (2) the LDR brachy itself, which is usually done on an out-patient basis w/o an overnight stay and (3) the follow-up MRI to confirm that the seeds are placed properly.

If you have specific questions about your dad, I would suggest you call Dr. Grimm's office and discuss it. For example, if his prostate is enlarged then he will be put on meds ahead of time to shrink it before treatment.

You might also consider HDR brachy which has excellent results as well.

Jim