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SMART - MRI Guided Adaptive Radiation Therapy

Posted by tjp1958 @tjp1958, Oct 3, 2025

I just completed the 5 treatment radiation therapy under MRI. It’s called SMART and the machine is called MRI-Linac. It’s non invasive, relatively simple, has similar success rates as RP, very few side effects, and no downtime. I kept up all activities throughout the treatments and maintained normal activities after completion. I am delighted and happy to share all I learned and experienced with anyone interested.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

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tjp1958 | @tjp1958 | Oct 4, 2025
In reply to @billkmed "Best of luck with your treatment - I completed my (5) MRI guided SBRT two months..." + (show)
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Best of luck with your treatment - I completed my (5) MRI guided SBRT two months ago in Portland, OR. Barrigel instead of Spaceoar. No ADT and doing well. PSA has already dropped from 10.1 to 3.7. Also 67 years old and active with intermediate decipher plus other complications. Was ADT prescribed for you?

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@billkmed adt would have been preferred but heart afib issues prevented it, so we went without.

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tjp1958 | @tjp1958 | Oct 4, 2025
In reply to @jeffmarc "@tjp1958 It definitely looks like the cancer has spread beyond the prostate. I would imagine that..." + (show)
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@tjp1958
It definitely looks like the cancer has spread beyond the prostate. I would imagine that if they’re doing MRI guided radiation, they would’ve hit the area that looked like it had spread to. You could ask the RO If that did happen just to confirm that they did cover that area and you Have “clean margins” as far as radiation is concerned.

That would be the only thing I would be concerned with. You are all 3+4 or less And nothing else that is looked for to be possible to escape radiation is in your biopsy.

Overall, it looks real good.

AI Overview
In a prostate cancer biopsy report, "tumor extends into loose fibroconnective tissue at the end of the core" means the cancer has likely spread beyond the prostate gland's boundaries. This is also known as extraprostatic extension (EPE) or extracapsular extension.

Here is a breakdown of the key terms:
Loose fibroconnective tissue: The tissue just outside the prostate. A pathologist views this material at the end of the biopsy sample, which marks the outer edge of the prostate.

Extends into loose fibroconnective tissue: The cancer cells are seen invading this tissue, which suggests they have broken through the prostate capsule and spread beyond the gland.

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@jeffmarc thx! Will do! I hope my experience can help others and I’m glad to discuss all my learnings with anyone searching for a solution!

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climateguy | @climateguy | Jan 14 7:14pm

That MRI-Linac in Portland is the closest machine to where I live. I'm very interested in being treated there with that machine. Did you have much of a waiting time to be treated?

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tjp1958 | @tjp1958 | Jan 14 9:29pm

No. A month or two. They did a mapping on 8/31 and started 9/15. Done 9/30. Superb.

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