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what are the key factors in term of selecting the doctor / medical facility for SRT?

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Prostate Cancer
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Posted 1/8/2020 4:42 AM (GMT 0)
please provide examples if one can

for salvage radiation therapy (SRT) are the factors

ADT options
the type of radiation medical equipment used (newer is better? which models are preferred?)
the radiation protocol (days and dosage)
the experience and track record of the doctor
the associated institution
Posted 1/8/2020 2:13 PM (GMT 0)
For me it was
1. A well reputed RO with extensive experience
2. That is using the latest technology (machines and software)
3. At a major cancer center. Where I could have confidence that the technicians are well trained.

I followed my surgeons advice to NOT try to negotiate with the RO (they know each other) and just take his advice on ADT, which I agreed to. I’m not sure if that was the right decision, but if I had not done it, and the recurred, I’d always wonder.
Posted 1/8/2020 3:14 PM (GMT 0)
I’ll echo what Pratoman wrote. And, for me, it was important that they had a urologist and social worker / psychologist on staff. Proximity to home was also a bonus, but not necessary, given the 39 trips for SRT.
Posted 1/8/2020 3:23 PM (GMT 0)
what Prat said.
Posted 1/8/2020 7:14 PM (GMT 0)
For me:
1. There was a center very close to me, on the way to work, in fact, so it was extremely convenient.
2. At the big cancer center an hour away, I asked the ROs if there was any reason NOT to have it done near my home and they said no.
Posted 1/8/2020 8:08 PM (GMT 0)
From my ART experience:
• Treatment location being convenient to home or work is important for obvious reasons.
• Equipment should be reasonably current (5-6 years old?) and fully capable of IGRT/IMRT (most likely SBRT also) such as Varian TrueBeam, etc.
• ART/SRT does not appear to have any protocol shorter that 35-40 treatments since it is a mop-op operation vs. aiming at anything specific. Daily dose typically around 1.8 Gy to limit surrounding damage.
• RO needs to have prostate treatment experience and have a RO educational background from known institutions and you should get along well with the RO.
• IMHO, the exact location or institution is not a controlling factor with standard ART/SRT beam radiation treatment as the RO makes the plan which is carried out by techs running the modern equipment, supervised by the RO's.
Everyone will have a different opinion on these ART/SRT items but I did not see the point of going to Mayo for daily treatments when I could get the same treatment on the same equipment from a Mayo trained RO, 4 miles from home.
Posted 1/8/2020 9:39 PM (GMT 0)
Pratoman

where was your SRT done ?

what ADT drug was used and for how long before SRT ?
Posted 1/8/2020 10:17 PM (GMT 0)
Jronne, my SRT was done at Memorial Sloan Kettering in NYC, the main campus. RO was Michael Zelefsky.

My ADT was a 6 month course. Dr Z started me on Firmagon, which is only available in 1 month shots. After the second shot it became apparent that I was having tough reaction at the injection site (inflammation around the abdomen), so he switched me to Lupron starting in month 3. 1 month shot, no bad reaction, so the next shot was 3 month shot and that was it
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