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Anybody who had SBRT wish they did Brachy instead or vice versa ?

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Prostate Cancer
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Posted 1/1/2017 2:21 PM (GMT 0)
Happy New Year,

After much due diligence and discussion of my case on this board I recently made the decision to start SBRT with Dr Michael Zelefsky at MSKCC. As a low-intermediate risk patient I was also offered low dose Brachy as an equally good treatment option ( as well as surgery which I dismissed ).
Are there any members who had SBRT and after treatment wished they had gone with Brachy or had Brachy and then wished they had gone with SBRT ? If so, I would like to hear your reasoning.
I think it is normal to second guess one's decision and therefore I am seeking thoughts on this topic prior to starting my treatment in 2 weeks.
Thanks in advance for your input.
Posted 1/1/2017 2:59 PM (GMT 0)
Bosco - My pathology is a bit like yours - favorable intermediate risk. I, too, researched many forms of treatment, including LDBT and SBRT. In fact, one of the RO's I met with indicated that if for any reason we started toward SBRT but could not go there (I am not MRI compatible, he wasn't sure if he would get enough info from CT alone), then LDBT would be his next recommendation.

That said, I am now almost 6 weeks post-toastie, and have no regrets - none at all. I believe that the SBRT actually will have greater efficacy than brachy, since the entire prostate (and any other "interesting" areas) can be targeted.

I'm sure that you have been through all of the learning to decide which treatment you want, as have I, but thus far after treatment, I have no regrets. I see that you plan your treatment with one of the top men in the field, too, so that should give you added confidence.
Posted 1/1/2017 7:19 PM (GMT 0)
It was a coinflip for me. I had the top practitioners of both SBRT and HDR brachy within a 10 minute drive. They were both reporting similar cure rates, and similar rates of potency retention (which was my #1 criterion). I finally decided it on the basis of convenience - it was easier to go in 5 times for about 5-10 minutes than to have 2 overnight hospital stays.
Posted 1/1/2017 7:29 PM (GMT 0)
Bosco, first of all I think you made a great decision.

I chose LDR Brachy and it has been VERY successful for me. Having said that, my interpretation of SBRT when I was treated (2008) was that it was relatively new and unproven. However, if I was deciding today it would be a close call between LDR Brachy, HDR Brachy and SBRT. All are excellent options for men of your (or my) stats and highly preferable to either surgery or traditional IMRT in my opinion...

Jim
Posted 1/1/2017 7:51 PM (GMT 0)
Tud:

You forgot to mention surgery, another fine option

Mel
Posted 1/2/2017 9:58 PM (GMT 0)
Bosco- you will do great and will be so happy when it's over which is really only a few short weeks away. 2017 will be a wonderful year for you. Please keep us posted on your progress. We'll be waiting....;)
Posted 1/3/2017 11:43 AM (GMT 0)
Thanks all for the follow-up and encouragement.
I'm sure I'll do fine but it's inevitable while I wait to start questioning my decision.
I see Dr Z today to sign consents and have my pre-op physical.
Fiducials scheduled to be placed in 2 weeks with the simulation procedure the week after.
I am told that they then need 2 weeks to design the treatment plan so that puts off starting the actual treatments until the beginning of February.
Can't wait for this to all be over....seems to be dragging on forever.
Posted 1/3/2017 1:17 PM (GMT 0)
Yeah, Bosco - It does seem to be taking forever, especially since so many of us spend an extended period of time learning and deciding which treatment is right for us. But think of it this way - we are the lucky ones who do have the luxury of time to decide, and if the docs need some time to get things just right for us, we have that, too.

Once you actually start the treatments, time will fly. I can't believe my last treatment was actually 6 weeks ago tomorrow. You'll do fine and will be finished sooner than you think.
Posted 1/3/2017 9:36 PM (GMT 0)
You have made your choice; it's a good one. Please get on with your life and don't look back.

PS: The urologist recommended conventional brachy followed by IMRT for me (Gleason 9). After 'looking around' and being somewhat of an 'experimentalist' after 30+ years in science, I decided to go for SBRT + IMRT. Details should be with my signature
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