HealingWell
Search Close Search
☰

SBRT and "Flow" Scare?

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 4/8/2020 12:40 PM (GMT 0)
Hi, everyone. I'm concerned about "Flow" following SBRT. I am scheduled for spacer gel, markers, and 5 treatments of SBRT in October at UW Madison. The delay is due to Covid19 stress on the medical system which is creating a backlog of non-emergency procedures. The RO wants to give me 30 mg of Lupron in June, a 4-month dose, with nothing more afterwards. This is to put me into remission during the waiting period and further ensure eradication of the cancer following treatment. I am Gleason 3+4.in the right mid and right lateral apex involving 80% of the cores in that area. Not looking forward to Lupron, and a bit concerned about "flow" after treatment since it is poor now. I also had s surgeon tell me surgery should be my choice, since he "didn't want to see me at 90 years of age in the ER because I couldn't pee." I'm approaching 72 years of age and would like to avoid surgery, but I'd also like to avoid the ER at age 90. Any input from the community is welcomed.
Posted 4/8/2020 12:53 PM (GMT 0)
Sounds like a very self serving surgeon trying to scare you into letting him cut you. I would fire him immediately. Ask him why he would be an emergency room doc in 18 years. Giving up on surgery?

Talk to the radiation oncologist specifically about your concern. Seek an additional assessment if you are still concerned. I avoided surgery for valid reasons and have been well served by radiation therapy as many thousands of men have. I share your concern about surgery. I am sure there will be other members that have had flow issues that can provide their experience. Often the surgery men can’t control the flow. So there are often adverse conditions on both sides.

I have never had the flow issues either before or after radiation therapy, so can’t provide first hand experience. I do have a good friend that at age 76 had SBRT last fall and he is doing great with no treatment side effects. In addition to PCa he had been treated for BPH and had flow problems. He says he is now better as the radiation and a few months of ADT has shrunk his prostate.
Posted 4/8/2020 12:55 PM (GMT 0)
Surgeons do surgery. So generally speaking, with some exceptions, that’s what they likely recommend.
Pretty much any treatment for PCa, has POTENTIAL side eff4cts. It depends on your condition prior to treatment, the extent of disease the skill of the oractitioner treating you, and frankly, some luck.

Many guys here have had SBRT and I’m sure will chime in shortly so stay tuned. I don’t recall a lot of stories about poor flow, that was permanent.
As an aside, I was G6 in biopsy, upgraded to g7(3+4) after surgery. I looked at SBRT and decided against it because the track record was only 7 years. So I went with surgery. I had a biochemical recurrence so had Salvage Radiation three + years later, finished 2 years ago. No issues. But my point is, I sometimes wonder if doing SBRT would have avoided recurrence in the first place. No regrets, I made the best decision I could with the data I had. But if I were age 72, like you, and was diagnosed today, with 5 posiitive cores, I would probably do SBRT.
But everyone is different.

Stay tuned for others with SBRT experience
Posted 4/8/2020 3:03 PM (GMT 0)
There are probably a half dozen current treatments for BPH. These include Uro-lift, Rezume, Prostate artery embolization, HOLEP, TURP, and various shrinkage drugs.

There certainly will be more by in the coming years. That surgeon was just scaring you.
Posted 4/8/2020 5:26 PM (GMT 0)
The choice of your treatment for PCa can be a life changing one. Keep learning as much as you can and explore all your options. I had good urinary function prior to SBRT treatment that remains today. I can’t comment on your flow issues but I can’t imagine the SBRT having a negative impact. The ADT should help stop any progression of the PCA short term and a benefit would be that ADT will make the cancer cells easier to eliminate once radiation takes place. I have a friend going through ADT now following disappointing results from surgery. He says the experience has not been bad at all. He credits this to staying physically very active. Good luck and keep us posted on your progress.
Posted 4/8/2020 6:30 PM (GMT 0)
Hello cpence,

Other than our ages, I'm 65, our situations are very similar. I am/was a 3+4, a low amount of pattern 4, all on the left side, mostly in the mid gland. My mpMRI indicated that my disease was contained within the organ. I did a lot of research, had a second opinion consultation at Duke Cancer Center, and had my biopsy slides reviewed by Dr. Epstein. My only objective was to determine what treatment gave me the best chance of a cure with the least side effects. Eventually I decided on SBRT via Cyberknife. I had the SpaceOAR gel, the markers, and five treatments of SBRT for a total of 36.25 Gy. My particular RO gave me Flomax prophylactically, and continued it for one month following the last treatment. I did not have any issues with urine flow beforehand and never had any during or after the treatment. If your current flow issues are the result of BPH, I can understand looking at surgery, but I would certainly look at how modern-day radiation can minimize most and maybe all side effects. I am currently a little more than seven months out from my last treatment. I have absolutely no negative issues with urinary, bowel, or impotence functions. My last PSA, about six weeks before starting treatment was 4.77. Three months after my last treatment, my PSA was 1.48. Six month PSA was 1.14.

If you have any desire to read my journey in great detail, I have documented it all on one thread here on Healingwell. I think you can find it by searching for my screen name. Best of luck to you!
Posted 4/10/2020 9:00 PM (GMT 0)
No flow problems here. See my history below. My URO / surgeon oversold his product and after considerable research, SBRT was my choice.
Posted 4/11/2020 12:37 AM (GMT 0)
hi, cpence! I was diagnosed with a similar biopsy pathology at age 68. I did a lot of research and evaluation, and chose SBRT (CyberKnife brand). My treatment ended almost 3 1/2 years ago.

Prior to treatment, I had relatively minor weakness of flow. Never needed any treatment. My RO pre-emptively prescribed FloMax during and after treatment. I really did not need it, and stopped it soon after treatment. I did have some urinary burning and discomfort at first, but that resolved within a few weeks. To this day, my urinary situation is, as far as I can tell, the same as it was pre-treatment.

My own non-medical opinion is that if you are OK now, you are likely to remain so.
Posted 4/12/2020 12:52 PM (GMT 0)
Thanks to everyone for the support and feedback. It has helped very much. As my urologist said about my particular choice between surgery and RT,, "there is no wrong decision." I think that's true going in, but some of us will regret our individual decisions after treatment is completed. Lacking a crystal ball, we all will have to make our choices and then own them. No mulligans! Thanks again for your input into my decision process. Its great to know I'm not alone.
✚ New Topic ✚ Reply