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Posted 7/12/2017 9:15 PM (GMT 0)
I'm one of the fortunate ones on this forum; low volume G 3+3. I'm posting since there are a lot of men in this category and the treatment options are numerous. I chose to be treated instead of AS due to the infection risks of repeated biopsies. Although the infection risk in biopsies is low; biopsies each year would increase the total risk significantly. I have several joint replacements (both knees and Rt. shoulder) and a blood infection would place my joints at significant risk. For my wife and I it came down to weighing infection risks against treatment risks. We're located in Western PA and my local treatment choices were limited to LDBT, IMRT and surgery. By driving 2 1/2 hours I could expand my choices to include SBRT at CCF (Cleveland Clinic). After a thorough consult wth Dr. Tendulcar (RO) at CCF on all radiation options we chose SBRT.

I'm a little over two weeks post treatment. Marker placement, simulation and five treatments went completely as planned. I drove both ways (5 hours RT) with no problems. CCF has six new Varian machines at Taussig Cancer Center. Four are RapidArc and two are Edge. I was treated on Edge 1 and actual treatment time was approximately six minutes once I was situated and lined up on the table. The machine rotates twice stopping every 60 degrees to take a mini scan and be certain everything is lined up properly before delivering the next radiation dose.

After the third treatment I noticed some mild burning when I urinated. No other negative side effects so far. The mild burning resolved on it's own about 7 to 10 days following treatment. Bowels, erections, sex all functioning with out issue. I was able to maintain my normal routine including cycling/spinning 60-70 miles/week. I have a PSA draw in three and six months and a follow up by video phone to review my PSA results in December.

In addition to the medical team at CCF I credit this forum and it's wonderful members and their excellent advice that led us to the correct treatment option for my wife and I. The only negative in my experience is that SBRT for PCa is not currently available in the Pittsburgh area. I'm completely happy wth my choice; no regrets.
Posted 7/12/2017 10:11 PM (GMT 0)
Nicely done and congratulations. My hope is that you, me and many other men sing the praises of CC's SBRT protocol for PCa years from now.
Posted 7/12/2017 10:32 PM (GMT 0)
It's always good to hear about good experiences at CC. My father was treated there for his PC back in the early 90's. They were doing cutting edge stuff then, and they still are.
Posted 7/12/2017 10:37 PM (GMT 0)
Congrats Terry!
Posted 7/13/2017 12:05 AM (GMT 0)
Good luck to you, Terry!
May I ask if you were advised to have ADT therapy before the SBRT?
I am wrestling with this decision myself.
Dan
Posted 7/13/2017 12:07 AM (GMT 0)
Terry, we have the same path report, and I, with the support of the staff at Johns Hopkins, have chosen to stay on AS, and avoid/defer treatment.

That said, if I were to have treatment, I would choose SBRT. Smart decision on your part.

Please keep us advised of your progress and of any challenges. Best wishes to you.
Posted 7/13/2017 12:24 AM (GMT 0)

Danioro said...
Good luck to you, Terry!
May I ask if you were advised to have ADT therapy before the SBRT?
I am wrestling with this decision myself.
Dan

Dan - The standard of care for low-risk and favorable intermediate-risk PCa does not include ADT. They typically reserve that for unfavorable intermediate-risk and high risk patients. In low risk cases, ADT has not been shown to have any disease-control benefit, but may have significant unfavorable side effects.

BTW, unless I've missed something in your pathology, your G3+4=7 would still be favorable intermediate risk.
Posted 7/13/2017 1:28 AM (GMT 0)
Danioro,
No, ADT was suggested either by my urologist or RO. My prostate was about 28 cc and LDBT was a monotherapy option in my case. If you have not already done so I would suggest a second opinion on your slides to confirm the G7. Feel free to contact me by email if you want additional info.
Posted 7/13/2017 4:01 AM (GMT 0)
Great report!

Keep us updated,
Andrew
Posted 7/13/2017 1:43 PM (GMT 0)
Terry,
Happy to hear of your recent success! I also live in Western PA. We are fortunate to have Cleveland Clinic and Taussig so close. Just finished 6 rounds of chemo. Lupron & Zytiga still ongoing.

Tendulkar is one of the best! Not to mention the rest of the PCa crew. And the clinic spares no expense when it comes to equipment, as well as the new Center.

Wishing you all the best in the future.

Mr. Bill
Posted 7/13/2017 3:03 PM (GMT 0)
Glad to hear it! Trust your news will be good going forward as well.
I was treated at CC over six years ago and will be going back for a follow up next week.
All the best to you.
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