I’m 69yo with a 3+4=7 GS; is SBRT a good choice for treatment?

@brianjarvis
Spacers and makers are required for SBRT by my oncologist.

@dekestet At your age and with your numbers, you might want to look at TULSA-PRO if you're able to travel.

I’m 65, Gleason of 4+3 and had RARP 3 months ago. You’ve gotten great advice from these fine folks, but one thing to consider is your current “bathroom” status. I also strongly considered SBRT. I had an enlarged prostate along with my PC, and was already having some peeing issues before surgery. One pleasant result of my surgery is that it solved all of the peeing issues caused by my enlarged prostate. I’m right at 3 months post surgery and fortunately, have regained full continence. Just another element of the PC puzzle to consider. Consider all aspects and know that you’ll make the right decision for you. Best of luck on this journey, you are not alone.

I’m age 66. 4+3 Gleason. Oligometastic w/one spot on pelvis and one on pelvic lymph node. Had SBRT late April ‘25. Not able to insert gel spacer due to my prostate being fused to rectum due to scar tissue from 5 biopsies. Very minor side effects early on (had to double up on Flomax), but none others since. ADT (Nubeqa, Orgovyx) for 6 months ending September ‘25. Currently, my PSA is steady at .19. Highly suggest you find a radiation oncologist that does a lot of SBRT’s. Practice makes perfect.

@glabelle Thanks for your reply; it’s reassuring to hear that you have good results with SBRT. I’ve already learned (the hard way ) that the right team is the only way to go.

@luger51 Thanks for your reply and supportive message. It’s been a real learning curve. I’m trying to make a fully informed decision before moving forward.

@luger51

70 years old, 1 core 3+4, pattern 4=8%, cribriform not identified, and 1 core 3+3. 15 cores taken at biopsy. Decipher score .58. Had SBRT at MSK in October 2025. Did barraged spacer and fiducials placed before starting. Some minor burning with urination for a few weeks but no other side effects so far. Very happy with my decision.

To answer your question from my perspective...Yes, SBRT is a good choice. I was 67 Gleason 3+4, PSA=9.3, MRI showed 4 positive lesions, biopsy confirmed this, my decipher=0.34, PMSA neg. Prostate 61cc
I had the Barrigel spacer placed one week before 5 rounds of SBRT one year ago on the Viewray MRIdian platform ( I did a lot of research of this platform and in my opinion it was the best choice for me, ). It was a excellent choice for me at the time, done at Thomas Jefferson. The team that treated me was nothing short of excellent. Very minor urinary issue after the 3rd treatment, but it cleared up rapidly within days. Some slight urgency of the bowel, but that also self resolved pretty quickly. I feel that right now I have no side effects at all, never a ED issue before or after treatments. I was scheduled to get a 2nd biopsy prior to me wanting treatment and I declined that and went right to SBRT, I did not want to risk another chance of the biopsy releasing cancerous cells again. At this point in my life I would not change what I did. My urologist at Hopkins explained how diet can cause prostate cancer as a very big contributing factor, since that was explained to me I have lost over 40lbs, by lowering caloric intake, but more importantly stop with the processed packaged foods, strength training and the weight has fallen off. Everyone is certainly different, this is just what I did at my choice.

Mack Roach is an internationally recognized authority on treatment planning for prostate cancer. He served as senior author for the guidelines for treatment planning by the American College of Radiology.

Dr. Roach explains that he prefers administering SBRT to his patients at this point in his career, in a recent interview hosted by P.C.R.I., especially for patients with low or intermediate risk localized PCa. He covers a few other topics as well.

I agree with everyone about SBRT being a great choice. But remember, SBRT is high dose radiation and about 18% of the population can't tolerate it well. You need to get a PROSTOX test to make sure that you are not in that 18%. See my bio for more info.