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SpaceOAR causing issues

Prostate Cancer | Last Active: May 1 10:25am | Replies (59)

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@vircet

Hi Phil,
I believe the values in your post-treatment report are in "centigray (1/100th of a gray)."
If I am correct, this means you had 45 Gy to the pelvic nodes and 60 Gy to the prostate bed.
I read in another literature that 60 Gy is maximum (I am not sure if this information is current).
It appears that Elekta MR-Linac is similar to the MRidian machine.
After my 5th treatment, I told my oncologist that, "You told me the MR-Linac is used only for patients without the fiducial markers. But the radiation team told me they used Elekta linear accelator to treat me."
The oncologist replied, "Our Elektas are linear accelerators. MRI-guided for radio planning. The MR-Linac is real-time MRI, for patients without fiducials. don't worry, all our Elektas are good."
Perhaps, it can't get better than that. Before my cancer center got the MR-Linac, all their prostate RT patients were treated with the older machines, MRI-Guided for radio planning but not real-time MRI during treatment. Based on machine loading and machine capacity, I understand that the lone MRI-guided-real-time machine cannot replace all the other machines in the cancer center -- if I heard correctly, a thousand patients a year. (If I was paying with my own money or my private insurer's money, perhaps I could have insisted on the Elekta MR-Linac. As it is, our taxpayer-funded medical care cannot accommodate all who prefer MRI-Guided treatment, with "MRI-guided for planning" as the second best choice for many.
Thanks for your comments. I am learning. and I hope our discussion can help others still researching on what linear accelerator machine they will be treated.

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Replies to "Hi Phil, I believe the values in your post-treatment report are in "centigray (1/100th of a..."

Hi Vircet, I don’t think you should worry too much about the different machines; you basically had Cyberknife, which is extremely successful with low long term SE’s.
It seems that I myself got more radiation (acc. To your estimates) and I had no Spacer either - we’re either both fine or both screwed😩
But if you rigorously followed the bowel and bladder prep I think we should be OK. All in all I think a gel spacer is a good extra layer of protection for the rectum, but my RO told me that his machine was able to shape the beam around the rectum, since everyday I had a cone-beam Xray as part of the protocol prior to active radiation. It ensured that all the structures matched up with the simulation. Yours used MRI mapping so you had the same thing.
Take it easy and enjoy that cruise you were planning - you deserve it! Best,
Phil