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Question for stage T2b guys who chose radiation

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Posted 3/21/2015 1:38 AM (GMT 0)
I don't want surgery for various reasons. I'm strongly leaning toward IGRT. Has this worked well for any of you guys?

Thanks
Tom
Posted 3/21/2015 2:19 AM (GMT 0)
I had that IMRT with a brachy boost and I'm doing very well. Have you investigated brachytherapy? Given some of your 4+3s that might be a better option. At the very least worth considering.

Also, congrats on the clean bone scan and being confined to the prostate!
Posted 3/21/2015 4:16 AM (GMT 0)
Three years out and I am doing fine. PSA very low.

Side effects are some mild ED and my hemorrhoids are slightly worse than before.

Other than that, I can recommend it.

but you should also consider LDR Brachy too. That worked very well for my brother.

Andrew
Posted 3/21/2015 6:04 PM (GMT 0)
My husband is starting IGRT in early May. He's had a lupron shot and will have his gold markers implanted on April 22. His stats are similar to yours, but his tumor was T2a. Am interested in any and all replies.
Posted 3/21/2015 6:28 PM (GMT 0)
goats...looking again at your diagnosis, I see your PSA is relatively high and puts you in the high risk group. To me that speaks to a greater likelihood that you need more than just IGRT as a mono-therapy. Is this something that you've addressed with an RO?

SueCAll...as mentioned above I had IMRT, although in conjunction with brachy and (like your husband) HT. As others have stated, it's a bit of an endurance contest but the SEs are few and I'm doing very well in the early stages. Frankly, the HT was a more difficult process.

BTW, congrats on the downgrade from Gleason 8 to Gleason 7. Unfortunately, John Hopkins changed me the other way as on their reading I went from a G8 to a G9.
Posted 3/21/2015 6:36 PM (GMT 0)
I radiation, IMRT and HDR Brachytherapy. Given my high risk dx I also had three years of HT.

I have done very well with no radiation side effects and glad I did not have surgery.

My brother-in-law used IGRT mono-therapy three years ago and is all clear. He was PSA 10 and G7.

I agree that you probably should be looking at more than mono-therapy. Look into HDR brachytherapy as well. G7 and some very loaded cores add risk, in my opinion.
Posted 3/21/2015 7:49 PM (GMT 0)
I was a G4+3 with a psa of 40. LDR combined with IMRT and 9 months of Casodex worked well. 6 years out and never had any side effects and psa is <.1
Posted 3/21/2015 9:51 PM (GMT 0)
I agree with Michael_T , JNF and JohnT that with your high risk diagnosis, you may need bigger guns than IGRT/IMRT monotherapy. Combo therapy with brachy plus IGRT/IMRT is much more likely to be curative for you. In fact, I just wrote an article about a recent comparative clinical trial that proved that one can get better results with a brachy boost than with external beam radiation alone:

EBRT + LDRBT boost provides superior cancer control compared to EBRT alone

- Allen
Posted 3/22/2015 12:26 AM (GMT 0)
your numbers are worse than mine, but I was G7, 12-12 positive and one core at 70% and another I think at 60. you can see that I had combo therapy and have been in remission more than four years post treatment.

I think it would be a mistake for you not to do a combination treatment because you do have a chance for a cure if you hit it hard. good luck.

ed
Posted 3/22/2015 12:38 PM (GMT 0)
Thanks guys for your input. Very helpful. Hadn't considered double or triple play. Will talk to doctor Tuesday, but he's a surgeon so I will ask to speak with a RO. When I was referred to him it was thought that it had probably gotten out and they wanted to debulk. I've been doing a lot of reading in the meantime including Walsh's book.
Posted 3/22/2015 2:31 PM (GMT 0)
Goats

I had IGRT/IMRT last summer and have another year of ADT to go. I had no SE from the radiation and only mild SEs from the ADT. PSA is undetectable. I didn't want surgery, and am glad I made this choice

Any of these combos should work.

Good luck will be thinking of you.

Carl
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