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EBRT or SBRT

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Posted 4/13/2015 5:33 PM (GMT 0)
I got back from the RO today he advises EBRT for my cancer. I wanted surgery but because of my ostomy that's not a good move for me, they would not be able the save my nerves, robotic is out. The surgeon would need to operate the old way.I'm 57 so I don't want my love life to be over. Has anyone had SBRT it seems so much better than 45 days of EBRT. Need all the advise I can get from you all.
Posted 4/13/2015 5:46 PM (GMT 0)
Joey, an "RO" may or may not have expertise in SBRT. I would advise going to an experienced expert in SBRT and see what he or she says. We have a number of members who have had SBRT including probably our most knowledgeable member, Tall Allen. If he doesn't respond to this thread you should email him.

Also, may I suggest that you include your signature when asking for advice...it helps us all since most of us are old and can't remember every situation!!!

Jim
Posted 4/13/2015 6:49 PM (GMT 0)
As Tudpock mentioned, my mentor Tall Allen is the acknowledged layman expert.

Thanks to his sage advice, even though I am Gleason 9, he identified 3 RO's who do highest risk Gleason:

1. Dr Chris King at UCLA who is my RO for 5 fractions that concluded 10-20-14.
2. Dr. Allen Katz in NY
3. a group of doctors in Toronto that Houseboy used

www.healingwell.com/community/default.aspx?f=35&m=2818301

www.healingwell.com/community/default.aspx?f=35&m=2727370

For lower Gleason scores, there is more choice in local RO's, as was the case for MikeM53.

Six months after, I still have no Side effects and undetectible PSA. I had my final Lupron shot last week and will discontinue the Zytiga after 9 months on Memorial Day 2015.
Posted 4/13/2015 6:50 PM (GMT 0)
IMHO, there is no justification for ever selecting IGRT/IMRT over SBRT. The oncological results and the side effects are equal or better with SBRT. Of course, the cost and the convenience are much better with SBRT. The only reason to do IMRT is if SBRT is not available to you - geographically or because of insurance coverage.

If you can have IGRT/IMRT with your ostomy, I can't think of any reason you can't have SBRT - but you have to talk to an SBRT specialist. I think it's a good idea to discuss rectal spacers with your RO whichever kind of radiation you get.
Posted 4/13/2015 8:43 PM (GMT 0)
IMRT is no go I have no rectum. I am going to get a consult with Dr. Collins at GU. He does SBRT. I live near DC. The RO I saw today does not do this procedure but he said that in the future this might replace EBRT. I hope my insurance covers this most don't not sure why. I appreciate all the help from this site so many people that have been where I am now.
Posted 4/13/2015 10:53 PM (GMT 0)
Joey,

EBRT means "external beam radiation treatment." That covers IMRT, SBRT or PT. If the RO you saw said that EBRT is OK for you, then how can IMRT be "no go?" I'm glad you're seeing Sean Collins - he's done a lot of studying of rectal effects of radiation.

Be sure to go into your meeting with your questions written down, and write down his answers too (or record them). It helps to bring someone with you, if you can. Be sure to bring your biopsy report, any imaging yhat was done, PSA history, ostomy report and any other diagnostic reports that may be relevant.

- Allen
Posted 4/14/2015 10:03 AM (GMT 0)
Good luck Joey. I had SBRT and you can follow my journey at the link in my signature line. Feel free to email me if you have any questions. I'm almost two years out from my procedure and doing very well.

Mike
Posted 4/14/2015 11:00 AM (GMT 0)
So happy to hear Mike.
Posted 4/14/2015 2:19 PM (GMT 0)
Hey Joey:

Just to support the above, I have had SBRT twice (to the prostate and 3 bone mets indifferent areas) and I have had clean bone scans since (the oldest now 3.5 years).

Houseboy
Posted 4/14/2015 2:35 PM (GMT 0)
I think this is the best option, i just hope that my insurance pays for this. I have federal BCBS PPO. I have reading quite a bit on this sounds much better than 45 trips to the office.
Posted 4/15/2015 12:38 AM (GMT 0)
I don't know how old you are but if you're on Medicare they will probably pay for it. I live in Kansas and they would have done SBRT in Wichita if I was on Medicare. But since I wasn't old enough yet, I had to go to Denver where BCBS did pay for it. Wouldn't do it in Kansas but paid for it in Colorado within a month.
Posted 4/15/2015 11:07 AM (GMT 0)
I spoke with the insurance yesterday they will cover this. I see Dr Collins on the 27th of this month.
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