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Radiation treatment option?

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Posted 1/25/2018 9:46 PM (GMT 0)
I have a choice for radiation.

either IMRT or IGRT

Any opinions?
Posted 1/25/2018 11:35 PM (GMT 0)
I had IGRT/IMRT. Usually you have Intensity Modulated radiotherapy (IMRT) with Image Guidance Radiotherapy (IGRT). IGRT uses Cone-Beam CT (low dose Kilovolt radiation) images to track the changes in the position of the tumor to more accurately pinpoint where the radiation doses should target. In addition to all of the benefits described when using IMRT, image-guided radiation therapy also allows Radiation.

They should not be mutually exclusive.
Posted 1/26/2018 12:22 AM (GMT 0)

microchip said...
I have a choice for radiation. either IMRT or IGRT.Any opinions?

Those are the same thing. IGRT refers to the image guidance done at the start of each IMRT treatment. I can't think why anyone would do primary IMRT without IGRT in the 21st century.

But more importantly, just why are they your only options? Are you with an HMO or Medicare Advantage Plan? Your best option (most curative) is whole pelvic radiation with a brachytherapy boost to the prostate, unless you have pre-existing urinary issues that rule that out for you.
Posted 1/26/2018 12:43 AM (GMT 0)
I am with Medicare Advantage Plan. Does that make a differenc?
I was told that my best option EBRT.
Posted 1/26/2018 12:51 AM (GMT 0)
Hi Microchip....I had what your talking about .....45 fractions....81 gys.....with my home situation at the time , and my weak urinary stream , I went with this. If it worked , I will say it was super easy with practically no SE`s.....I`m coming up to my 4th PSA check in April and so far ,so good.....many are going with the newer radiation treatments now ...fewer fractions.....and adding the HDR in for the knock out punch, but in my case it was questionable whether it was necessary and possibly over kill? who really knows ?.....I`m very happy with my treatment and do recommend the IGRT........but do your homework and listen to the guys who have had the newer types of radiation.....David.....e-mail me if you want more info on my IGRT
Posted 1/26/2018 12:52 AM (GMT 0)
A Medicare Advantage Plan will often not let you go outside your provider network for treatment. Your Plan may or may not offer brachy boost therapy. I don't know why you were told that IGRT/IMRT was your best option. You may have peculiar urinary problems that would make brachy boost tough for you. You should talk to an expert in that kind of therapy. It's up to you to go out, find doctors and make appointments. Your ADT should keep the cancer from progressing while you take charge of your own health.

Read the following and see if you still agree that IMRT is your best option:

/pcnrv.blogspot.com/2017/03/brachy-boost-gold-standard-for.html
Posted 1/26/2018 12:57 AM (GMT 0)
Have pre-existing urinary issues? that's was got me into this situation.I saw a urologist because
I was getting up 3 - 4 times a night, had difficulty controlling and had week streams. I guess I can call
this urinary issues.

microchip
Posted 1/26/2018 1:40 AM (GMT 0)
Fldrifter,
Thanks for you interest but you email address did not work for me in outlook, got
undeliverable message. Try emailing me at (email address removed) and I willreply.Microchip

Chip, I removed your email address from the body of your post so the spammers don't latch on to you. I see you have activated it in your profile so members can now reach you. Jim

Post Edited By Moderator (Tudpock18) : 1/26/2018 3:35:50 PM (GMT-7)

Posted 1/26/2018 1:40 AM (GMT 0)
You'd have to talk to a brachy doctor. It may well be that the two months of ADT re-establishes good urine flow. It will certainly shrink your prostate. You didn't say how big your prostate is now, but a smaller prostate allows you to have LDR brachytherapy. Prostate size doesn't matter as much for HDR brachytherapy, but it may be harder to find a practitioner. You can't start radiation for at least 2 months anyway - plenty of time to make appointments with specialists. At Dana-Farber, the man to talk to is Paul Nguyen.
Posted 1/26/2018 1:57 AM (GMT 0)
Thanks Allen,
I will reach out to see if I can get some info.

Micro
Posted 1/26/2018 4:22 PM (GMT 0)
Tim Allen,

To answer your question, my prostate size is 137 cc

micro
Posted 1/26/2018 4:48 PM (GMT 0)

microchip said...
Tim Allen,

To answer your question, my prostate size is 137 cc

micro

i'm not too sure of Tall Allen's comedic skill, but I trust his advice on PC. turn
Posted 1/26/2018 7:59 PM (GMT 0)
I am funny, darnit! turn

That is some prostate! It's size would preclude LDR brachytherapy for now, but the possibility may open up after it shrinks. I think the ADT will get you peeing a lot better.
Posted 1/27/2018 3:58 AM (GMT 0)
Mine app 61cc at the start, after short term ADT and external beam radiation down to 26cc in a few short months, allowing LDR brachy. That's not the whole story though. Anatomy plays a part, having to due with pubic arch interference. So I was good with that one.

I also had other urinary issues that were corrected in the middle treatment. Point is, don't rule out any treatment until you have thoroughly researched all possibilities. I went from not being good candidate, to a very tolerable treatment protocol.

That means finding the most experienced practitioner in the chosen field who specializes in only treating the prostate.
Posted 1/27/2018 10:52 AM (GMT 0)
I am currently looking at 44 radiation treatments starting in March.
With a current volume of 137cc I would be very happy to see a considerable
reduction as you had.

I am currently debating between two very capable prostate cancer doctors

Microchip.
Posted 1/27/2018 11:12 AM (GMT 0)
thanks everyone for your postings. Helps a lot.
I think I am making good progress'

Microchip
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