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3C, PPC 8/12, highest GG5; T1c N0 M0 - 5 SBRT sessions to Prostate?
Prostate Cancer | Last Active: 1 day ago | Replies (18)Comment receiving replies
Jeff,
Thank you for all the information; it's very helpful. My husband is being treated at Duke Cancer Center in Durham, NC, and the radiation oncologist is very nice, but young! He finished his residency in 2024, and after our consult with him, I wondered if he made the decision to only radiate the prostate with 5 fraction SBRT, or did he discuss the treatment with a tumor board or fellow radiation docs. As you wrote, I must assume cancer cells have gone rogue and left the prostate, but the radiation treatment plan will not hit any areas other than prostate. Can patients get a second radiology opinion at the same cancer center; do I ask the radiation doctor to confer with more seasoned doctors, or do we go elsewhere for another opinion?
My husband intends to take Orgovyx and Nubeqa for two years; I just don't know if the 5 fraction SBRT only to the prostate is smart in my husband's case.
I plan to request the Decipher test - thanks for this suggestion.
The doctors have implied this can be "cured" rather than treated and subdued. This may not happen, but I'd like to give it the best shot. My husband will follow (without question) everything the doctors say, but I prefer doing my research.
With gratitude,
Sarah
Replies to "Jeff, Thank you for all the information; it's very helpful. My husband is being treated at..."
@scary1 I would agree with others that IMRT might be the better option; by telling you that 2 years of ADT are necessary, the RO is intimating that the cancer could be in the nodes and surrounding area already even if scans are negative.
Yet, he is only targeting the gland?? Doesn’t make sense.
Your husband should probably go on Orgovyx right away to arrest any growth/spread while you get a second opinion.
Remember, all radiation is cumulative; it all adds up no matter what! Laymen think that 5 huge blasts are really more powerful; but 25 or more, in smaller doses, add up to the same killing effect.
Five sessions of ‘X’ amount of radiation is equal to 25 lesser sessions of the same total amount.
But it’s where that dose goes that really matters.
You need the nodes treated as well, IMO.
Phil
@scary1
Just to follow up on a doctor at Duke
While you want to see a radiation oncologist, you really should get a GU oncologist involved in this case because you have a serious cribriform problem.
This doctor is really highly respected and well-known as an excellent oncologist. You would be better off contacting him and getting help. He will refer you to a radiation oncologist that would be ideal for your situation..
Duke North Carolina
Dr Daniel James George GU Oncologist
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@scary1
I would definitely want to get a second opinion on this. IMRT radiation may make more sense based on the problems your husband has. Cribriform is Probably going to make it so that his cancer will come back if he has not treated To the prostate and the prostate bed and lymph nodes in that area.
That is a very young RO you are working with you really need to speak to someone else that has a lot more experience with what’s going on. If you can’t get that answer at Duke, you need to go somewhere else. Here is the name of a top notch Oncologist that is not far from you. It will be worth going the couple hundred miles to see this doctor and get an Opinion from an expert.
Bethesda Maryland
Sibley memorial hospital
Johns Hopkins, school of medicine
GU Oncologist
Dr. Channing Palmer
With all the cribriform Your husband has a Gleason nine you need more choices. They say T1c But the cribriform Makes it much more aggressive.
Were any of these things found in the biopsy intraductal, ductal,, Seminal vesicle invasion, EPE or ECE. (Extraprostatic extensions extra capsular extensions). They can make the cancer much more aggressive. You need to take a close look at the biopsy and see if any of these are found.
Orgovyx and Nubeqa Are a good choice with the serious case he has. I’ve had prostate cancer for 16 years had surgery and radiation and three more reoccurrences after that. I’ve been on a few different drugs and then now on Orgovyx and Nubeqa And that has kept my PSA undetectable for the last 28 months. I do have a genetic problem, BRCA2, Which keeps my cancer coming back. If you can’t get Nubeqa (Darolutamide) Approved apalutamide Would be another good choice and would definitely be approved. It has more side effects, but works very well for most people.
Has your husband had a hereditary genetic test? Is there a breast cancer, Prostate cancer, or Pancreatic cancer in his family. Those can be the cause of genetic problems. You don’t mention his age and that is a definite factor in treatment. Genetic problems can lead to early reoccurrence.