Finally Moving Toward SBRT....I Hope?

I'd be surprised if they found mets.

Likely you'll be good to go.

Waiting for tests is a killer,
Hang in there,
Andrew

I can't add much, and I can't comment on the MRI, as I never had one. Having a cardiac pacemaker rules out MRI's for me, but Dr. Hirsch was fine to move ahead using the CT scan for planning.

As Allen mentioned, the markers are 15 minutes of discomfort, then back to your day. Then you're just waiting for them to build your plan and move on to treatment. The treatments are actually relaxing - very calm in that lead-lined vault where they keep the equipment. You probably even get to choose your own music to listen to - at least I did.

You're almost there!

19, I know it's easy for those of us who have been through it to say, it will be over before you know it...but it is true nonetheless. If you indeed get the balloon, know that the inconvenience and discomfort are for a purpose, and I would trust Dr. Freeman's decision on that.

Another thought that might be of some help, and maybe others can chime in: I took two Aleve tablets daily just before and during those two treatment weeks to stay in front of resultant gland swelling. A nurse suggested that because there could be inefficient bladder emptying for a little while, cranberry pills could prove useful. And along those lines, I asked my doctor for the Flomax prescription, in advance, just in case...as it turned out, after treatment 4 of 5 i was glad I had those caplets.

Good luck with your test results and your treatment!

Hey Steve..... Thanks for the suggestions and at the point that I know that treatment is actually scheduled, I will load up on NSAID'S, cranberry, and maybe the flomax. I do have total confidence in Dr Freeman and know that I'll be in good hands...... And I guess that since I tolerated the baseball bat just fine yesterday, a 🎈 will be a piece of cake if necessary.

0311.... Your comments are inspiring for sure and I hope to have as successful an experience as you. Btw, your signature indicates the PSA bummer, but isn't that small an increase more or less expected as a bounce on the way down to your eventual nadir?

I'm sorry you had the rectal coil. They used that a lot when all the MRIs were 1.5T, but now that 3Ts are prevalent, many believe them to be unnecessary. Did Dr Freeman know you had a rectal coil? The reason I ask is because the coil changes the shape of the rectum and prostate and makes it difficult to fuse the MRI image with the CT you will have after the fiducials are in.

Some ROs do use a rectal balloon during SBRT treatment, but most don't. It stabilizes the prostate during treatment. It pushes most of the rectum away from the prostate but pushes some of the rectum into the prostate. So the point dose - the highest dose received by the rectum - may be actually higher with it than without it. There is a randomized clinical trial now investigating whether there is any benefit to a balloon or a spacer compared to using nothing. There is no substitute for tight rectal margins and dose constraints, and checking for bowel distension.

Do NOT take cranberry! That will stimulate the kidneys to produce more urine -- the last thing you want to do when your urinary tract is irritated. For a few weeks cut down on acidic juices, coffee and drink only when thirsty. Otherwise you'll be getting up all night to pee.

Steve-

Here's the MSKCC study using Viagra:

www.jurology.com/article/S0022-5347(14)00355-3/abstract
(note that after 2 years, there was no difference - but the dropout rate was high and the men were older)


Here's the Mayo study on Cialis:

jamanetwork.com/journals/jama/fullarticle/1853160

But there were reservations raised about it:

jamanetwork.com/journals/jama/article-abstract/1896972


Here's an uncontrolled MD Anderson study using Cialis on guys having brachytherapy:

www.brachyjournal.com/article/S1538-4721(14)00634-5/fulltext


So the data are not convincing for the use of any ED meds after radiation. I used it (low dose Viagra) anyway. (If nothing else, these ED meds improve urine flow.) The goal is to prevent fibrosis in the blood vessels. It's probably true that daily orgasms may accomplish the same benefit.

Jim, Steve, TA and Paxton......Wow.....lots of information to digest. Got to take time to think through all this. As always thanks for all the encouragement.


YEA!!!!! Got a call from Dr. Freeman and the first thing she said was that she had nothing negative to report from the scan results......Good grief...what a relief!!! Then she went into the details of the report. Bottom line is that there were no mets, absolutely no issues outside the prostate. Seminal vesicles, nerves, etc. all ok so as Dr. Freeman said, she now considers me fully qualified to be a patient of hers in the Cyberknife treatment. So now we are setting up a transperineal fiducial marker placement followed by a CT scan and a standard MRI then the treatment plan will be devised. I will be provided a copy of the treatment plan which will be implemented at the Cyberknife Center of Tampa Bay. The relief I feel about knowing that after all this research and trying to learn about this dreaded disease and treatments for it is absolutely palpable I guess because once a decision is made on a preferred treatment, one doesn't like the idea of it getting thrown off track. Anyway, I'm good to go and after the remaining preliminaries, I'm looking forward to being on the "post toastie" side....and you know, without the education I received from all the good people on this site, I would have made what very likely would have been a terrible mistake for me personally and proceeded with an initial treatment plan that had very little basis for preference in my particular circumstances.

tarpoon,yes bounces of the PSA are normal after SBRT,some get them some not.You are on the right track.You made a great decision.Best of luck down in Fla.

0311 and Paxton.....Thank you both for the encouragement and vote of confidence. While I obviously still have "work" to do, for me, at least emotionally, it's all downhill now. It's really a strange feeling when one is actually going through all these diagnostics to essentially "qualify" for a particular treatment. And I really do feel that SBRT offers me the best overall outcome potential, from cure to minimal recurrence possibility to quality of life. And Paxton, you are so right about this site. It's all about varying viewpoints, facts, experiences from individuals and then applying all that one learns to your personal situation and making what you believe is the best decision. That's what I've been able to do and I know I can move through the rest of this process without looking back.