Where you introduced to HDR BT

During my in-depth analysis, I learned a great deal about HDR Brachy therapy. I sure didn't expect a physician who doesn't specialize in this unique intervention to tell me about it.

...and just how did YOU discover it?

Subdenis said...
... they did a great amount of research on treatments prior to choosing surgery but claim they were never told about HDR-BT. In your investigation/meetings with RO where you given that option?

I was given several brochures describing various treatment methods including Cyberknife and Proton beam, but was told I was not eligible for CK and that my insurance would not cover proton. I was skeptical of traditional seed implantation (though my father used to do this when he was alive and practicing) and many of the EBRT options would require too many visits. We were in the middle of retirement relocation.

The combination of temporary robotic seed implantation with EBRT was never presented specifically. Frankly, there is little information to be found online even today. I'm not sure if it was commonly available in many major hospitals two years ago. Nor am I able to find any clue as to when this form of treatment was first developed or became mainstream (if it even is that today).

The best description I could find is at cancer treatment centers, a for profit corporation with various treatment facilities (www.brachytherapy.com/prostate-cancer.aspx). Frankly, given that my original urologist wasn't even able to hit my tumor with over a dozen needle sticks, I'm not sure if I'd trust a robot guided only by ultrasound to go poking around my rectum and bladder.

If anything, I would have loved to have known a couple years earlier that I had cancer... say around 2012-2013. Anyone know who was doing HDR Brachy five years ago?

The RO I spoke with at Duke said they did not offer HDR or SBRT for that matter. I have only learned of these treatments via Internet research.

My doctors only recommended treatments that were done at the local hospital and were covered by my health plan. That list included surgery, IMRT/IGRT, and LDR brachy. I would have had to pay out of pocket for other options so they didn't even mention them.

Still, I am 100% happy with the choices I had and the treatment I received.

Andrew

I’ll second Tall Allen’s comment about the necessity of “the patient to do the legwork."

While I was undergoing chemotherapy I read about the prostate cancer treatment “Dream Team” at UCSF. Subsequently, I self referred and met with an excellent UCSF MO specializing in prostate cancer that immediately connected me with an RO at the university. The RO and his residents advised me about and performed my radiation treatments: IMRT, HDR-BT, and SBRT. They pointed out for my specific condition that data gaps existed that precluded them from projecting how the treatments would affect my longevity. Nonetheless, I was happy that they did note that the treatments would substantially delay my experiencing many of the symptoms normally associated with the cancer progression.

_____________________________________________________________________
Age 54@Dx 3/16 PSA 22; Bx Rt: 5@G5+4; 2@G4+5; L: 7 neg.; 4/16 NaF PET-CT, L5&T5 mets, T3aN0M1
1/17 Combidex MRI & 68Ga PSMA PET-CT (4 LN’s+, 2 PSMA avid); 5/17 3T MRI, L5&T4 mets, T5 inactive
Tx 4/16 Lupron; 6/16 Taxotere; 2/17 IMRT 45 Gys (prostate + 2 PSMA avid LN’s); 4/17 HDR boost; 5/17 SBRT (L5&T4)
PSA 0.21-11/16; 0.20-12/16; 0.18-1/17; 0.25-2/17; 0.28-3/17; <0.1 since 4/17

My uro surgeon said no surgery. He said HDRBT was the best and have me the Fortune article about Andy Grove.

And we want from there.