Gleason 6 SBRT

I have been reading here for over a year after my biopsy in 2018. This site has been a Godsend of information and ultimately was the major player in deciding my course of treatment and was the assurance I was making the right choice.

My background, I was diagnosed 11/24/2018. G6, T1c , one of 12 cores 3%. I was age 69,PSA was 9.7 and went on AS.

PSA continued to rise reaching 11.3 in May of 2019. I discussed options with my urologist and decided I needed to take action. My urologist recommended seeds. I then met with 3 different RO’s. The first recommended 44 treatments over two months. It was at that point I made an extensive deep dive into this site.

I read everything relating to RT as far back as six years. Long story short it became apparent that SBRT should be at the top of the list. I also did a lot of reading about SBRT outside of this site confirming what I was reading here....most reassuring!

Met with the head of RO for Piedmont in Atlanta. He patiently went over my options taking nearly 2 hours. I told him I was really interested in SBRT. He said he only did high dose BT but another RO in his dept. specialized in SBRT. I got an appt. with him a few weeks later. After lengthy discussion with Dr.Levitt I was scheduled for late Jan 2020.

I had my urologist implant three gold markers in my prostate along with a spaceoar. It was all seem less and was as brief as the biopsy which he also did. Both times he used conscious sedation which is terrific with no hungover feeling afterwards. He calls it the Ritz Carlton. As a side note the only SE was no joint pain bending over to get the dog dish later that day. I should have asked him for some takeout .

The five sessions were basically a nothing burger and we’re completed over two weeks. Total dose was 34gy. I had very minor SE starting 2 days after completion of treatments. Some burning when urinating that steadily decreased over two weeks. My RO told me not to be surprised if SE develop as much as three months out. Still nothing yet and I’m virtually at 3 months now.

I go in for my first PSA test tomorrow so the marathon continues. My follow up with my urologist is next week.

Thanks so much to everyone on this site. Don’t know where I would be today if I had not found this site. You do indeed have to become your own advocate.

Welcome and thanks for the great report. SBRT is a great method that is modeled on HDR brachytherapy. Great to see your initial progress.

I assume the Dr. Levitt is Chad Levitt. He is a premier radiation oncologist and always gets the highest marks. He treated my wife nine years ago for a recurrent breast cancer. She had complete breast radiation for her first breast cancer 14 years before. He performed a very tricky radiation method that several other radiation oncologists wouldn’t and she did great. He is the best. Glad you found him.

Welcome to HW.

SBRT is a great choice. Do keep us updated on your progress.

Andrew

Welcome and I’m glad you’re sharing your experience here. It’s a great place to find first hand information from guys fighting this disease. My RA reminds me this is a marathon and not a sprint. My experience is much like yours in regards to side effects and a I’m very happy with my choice. I’m almost three years post treatment and everything functions very normal. Don’t fret too much over the upcoming PSA’s. If you look at my signature you can see they can be a little bouncy and that can be very typical.

2019guy,
I had a mri guided biopsy. In addition my urologist had me undergo ct scan, bone scan, site specific mri and full body mri and the RO ordered a site specific mri jus prior to SBRT.

As a side note my RO wanted me to have a colonoscopy before I had SBRT which called for another mri. It’s a good thing I am not claustrophobic. I might have ended up a real basket case. My wife can’t even handle the thought of one. Also for anyone interested my RO uses a Varian True Beam for the procedure. The one disappointment is that I didn’t get the x-ray vision I was hoping for.

Just got my first post SBRT PSA read. I had blood draw 3mos after treatment. PSA is now 1.8 down from PSA of 14.1 taken just before fiducial implants. Was unaware till now that it had gone up that much in a little over six months.

My urologist said I was his first patient to have SBRT and he was very impressed. He suggested next PSA check in 6mos. I told him every 3mos for the first year and he said okay. Just trying to stay proactive. Pretty hard to see a trend waiting on 6mos intervals.

Great initial results. Remember a few things about using radiation as an initial treatment.

First, the PSA reduction to the low point (nadir) can take from 24 to 60 months, and what you want is continued reduction. The generally accepted target is to get to under 0.50 PSA.

Second, since you still have a prostate it is normal to express some PSA. Not all radiation men get to undetectable, and that is OK.

Third, it is usual to experience an upward PSA bounce in the 18-36 month range. This is generally thought to be when many of the PCa cells finally and express the last breath of PSA.

Fourth, once you reach your nadir, you are considered to be in complete remission so long as your PSA stays under your nadir plus 2.0.

You have chosen very effective treatment by a top doctor. I agree with your choice of using three month testing for the first year or two. Particularly to find your nadir and detect any bounce. Now is time to relax and get on with the fun aspects of life. You have this one handled well.

Bilbobagum said...
2019guy,
The one disappointment is that I didn’t get the x-ray vision I was hoping for.

You will also be disappointed to find that you will still need to turn on the bathroom light to pee at night. Urine will not glow in the dark. . .

Hello, Bilbobagum ---

That's an impressive drop in PSA values, already -- from your recent round of treatments.

From that score, you can be assured that your treatments did a world of good!

It's helpful to know that you went back into the archives here, going SIX years back, to glean first-hand experiences.

It helps members here to know that their PAST posts can help FUTURE readers.

Thankful to hear such good results from your recent treatments!

Fire up the grill, or get some take-out from your favorite restaurant, and do some CELEBRATING this weekend!

Sent with my best,
Iowa State University - # CYCLONE Fan

Wayne Tex

I think your statement about choosing the right RO is critical. I interviewed three. I chose Dr. Levitt at Piedmont in Atlanta because of his length and depth of experience. He has been using SBRT since 2006 and has treated many cancers other than PC. The face to face interview I had with him went quite well. No red flags and we seemed to be on the same page. Once again I cannot understate the need to be proactive which by the way was a first for me from a medical standpoint. I was somewhat uncomfortable at first but in the end helped me to reach a course of action with no looking back.