SRT Questions???

Met with my Uro and two oncologists this week to discuss further treatment for rising PSA after RP. I received 3 different recommendations: SRT, SRT with 6 months of HT, and SRT with 2-3 years of HT. The rationale for 6 months HT was my gleason 8 and the need to beat up the PCa to make SRT more effective. The rationale for SRT with 2-3 years of HT was studies that indicted that it had a better outcome (as opposed to no HT or HT for shorter periods of time) in people that had ART. It seems to me that most people here have HT just to hold off progession of PCa until SRT can be started. Am I wrong? Have others had SRT with HT. Have outcomes been favorable? Has anyone gone as long as 2-3 years in connection with SRT alone?

Also, with regard to the radiation oncologist and facility (equipment and techs). Is getting the best one as important as a surgeon for RP. When I had surgery it was a difficult and one-time procedure with significant ramifications. I wanted the best person that I could get and was willing to travel if necessary. With SRT it isn't as easy. You have to be available near the treatment facility and Dr for 7 week. The Drs and facility near me is good. But if I travel two hours I get a Dr with a very good reputation and a top self facility. Is it worth the effort of a 4 hour round trip every week day for 7 weeks.

I would appreciate any comments and recommendations.

Hi BB,

What ever decision you make will be the right one for you. If I was in your shoes, I would definitely go for the best Dr and the best facility. 7 weeks will pass surprisingly fast, but you will have to live with the result for the rest of your life. The decision of cause rests with you. What's right for me may not be right for you.

All the best to you whatever you decide.

Magaboo

BB

I'm due to start RT on Monday in Amsterdam.
It'll take me about two hours each way.

I think that the most important thing with RT is the planning stage, not specifically where the procedure is carried out.

IE what matters is the knowlegde and skill of the person examining the images from my CT scan to work out exactly where the prostate bed etc is and thus where the machine has to aim.

I have the idea that once the "coordinates" of the target have been programmed into the computer the machinery basically takes over. There are simply some human technicians who ensure that the tattoos on my body are alligned correctly with the machine before they press a button.

It does occur to me that it ought to be possible to email those coordinates to the hosptial that is ten minutes away from home so that that the local machine and local technicians could treat me.

My team are not planning to give me HT at this stage.

Meanwhile I am not enjoying the weekend as I have got a bad cold. Coughing, sneezing, a nose that is running like a tap, sore throat, lost my voice etc, so not keen to even go outside, let alone go to Amsterdam.

Alf

Google the abstract and information on 'Bolla Study' it did show that patients did fare better or longer in this study and seems to have value, how much, how perfectly, look for yourself. As primary treatment I did the concept of Bolla study with neo-adjuvant ADT3 5-6 months before radiations, and ADT after radiations (total of 2 yrs.), then switched to different drug used intermittently thereafter (which I posted on a number of times). If you look at Bolla results, they are impressive differences....one has to weigh the trade offs and decide for yourself. You could consider various other drugs in doing similar works(discuss with oncologists if you are curious), uros all push Lupron and their equivalents, they don't prescribe other choices, some onco docs do.

Based upon my original stats and total urinary blockage from PCa (bad stats), I believe this protocol and the specialized radiations helped me to get this many years, thus far (8 yrs.+). Also, quality of life is especially decent after getting off of ADT drugs, thereafter.

Weigh everything is probably a good idea.

BB,
I could have gone to Atlanta which is a 2 hour drive one way, but chose a place 25 minutes from my home. He did not have the same great reutation that I would have found at Emory but the trip would have taken it out of me. I discussed all this with my URO and he even said I should go to the closer facility and recommended the Oncologist to me. I am pleased with my tx there and didnt have to dread a long drive thru horrible traffice. But that just my take on it.
Michael

Thanks Michael. This is my dilemma. Will the treatment be suffiently better. Probably no way to know. I't helps to get different views. In the end it will probably come down to piece of mind verses the wear and tear of the daily drives. Which I am sure will become more difficult as the treatment progresses. I also will have to deal with the job issue. Looks like you didn't have HT with SRT?