Need help deciding which radiation treatment system i should go with.

A valueable book for me was "You can beat prostate cancer" Marchini.
I had psa 98. had proton treatment, and 2 years on lupron and chemo abiraterone and prednisone.
If I had a do over I'd only do 1 year.

I didn’t see any discussion of the gel spacer. It doesn’t matter what kind of treatment you get, a spacer should be inserted. There is a minute gap between the rectum and the prostate (~1mm). Some doctors have done the procedure so many times they don’t think they need it. But you are the one that could fall into the few that end up with rectal burn or other problems. Don’t let the doctor’s ego prevent you from getting better protected.

I had 28 sessions of IMRT radiation treatments for the prostate. The RO said it was very accurate in targeting the cancer before I started. The side effects I have now 9 months later are frequent urination/burning and bowel movements 3+ times a day. If I could do it again I would get a proton radiation treatment. Both of the ones you mentioned are photon radiation. After everything I have read I would find a proton facility as they are harder to find but it would be worth the drive in my opinion if it is farther away. Everything I have read says photon radiation treatment regardless of the delivery, ie IMRT, SRS or SBRT, will leave you with side effects. When I was going thru my treatment I had to meet with the Doctor once a week and when the side effects started he acted like that was a normal outcome for pretty much everyone. They say they should go away in weeks or a couple months but 9 months later I am still having them non stop. My RO also had me get the "gold seeds" inserted for a more accurate treatment as they are a better target but the RO I had during treatment said that was redundant the machine is as accurate and in the end didn't help anyway as the radiation obviously hit the bowels and the bladder & urethra to give me these side effects. I just hope incontinence is not in the future as I have read that in some years later that happens as well. Anyway, my 2 cents. Good Luck.

@suzdog
I’m not sure if you’ve heard about this, but I heard about it recently and thought I would at least mention it.

Pyridium (phenazopyridine) is specifically used to relieve the burning, pain, urgency, and discomfort associated with urinary tract irritation, which often includes the burning sensation while peeing.

It is available over the counter

Have you tried this?

@jeffmarc Thanks for the referral ! I may give that a try if the burning gets worse. Right now it's just annoying and tolerable. I just hate the every 2 hours need to go when I am ingesting liquids. Really sucks.

I have posted this previously, has anyone’s RO said SBRT5 treatments are as efficient at minimizing side effects and curing cancer as any other radiation option ? I am scheduled to start 5 SBRT sessions at Mayo Rochester with spacer and markers in place . Pat D

Pat - yes. I finished Sbrt5 a month ago and have been extremely happy. I am glad to discuss if you want to drop me a message.

@jeffmarc I believe this is also known as AZO and it is fantastic. I used it twice in the month following radiation and it cured.

I suggest going to PCRI.org You-Tube videos and search for Brachytherapy 101 and also watch the Q & A after the presentation. Ask if optimal radiation dosing over time in the form of interstitial radiotherapy [(LDR: permanent seeds [Not HDR] ) is available at your chosen site. If not where / who would be available, The Q & A mentions several other providers who have also performed over 5,000 procedures . Newer trained urologists unfortunately are not given the opportunity to skill up. In Europe brachytherapy ['low dose' ] is increasing; whereas in the USA. it has been decreasing.

@packman7
My brother had the five session SBRT treatment. Four years later, he’s 80 and still around and doing just fine. He had a Gleason 4+3 and no spread.

I know a lot of other people that have had it and it worked well for them.

At the latest PCRI conference there was an RO Who discussed SBRT in detail and went into the fact that it really works better than other radiation treatments because the higher dosage kills the cancer more effectively.