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← Return to SBRT: Every day or every other day; proton or photon
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SBRT: Every day or every other day; proton or photon
Prostate Cancer | Last Active: 9 hours ago | Replies (22)Comment receiving replies
@johnt15 @bjroc
John, looks like I'm on the same track you completed. Do you know which machine they used. Was it a Varian Ethos photon or Hitachi proton . I'm very concerned about margins and not sure if I'm worried a lot about something I shouldn't.
What's the tradeoff for tighter margins of the Ethos vs the "no exit dose" of the higher margin Hitachi Proton? It may be they decide if your prostate is very close to bladder neck and they need the tighter margin of the Ethos.
Was that part of your discussion with your doctor? My Dr at Mayo Rochester doesn't communicate directly with me . The last email was from a nurse practitioner who assured me the Dr will do whatever is best.
My appts. for markers and Space Oar are already made for June and most treatments start within 2 weeks of that.
Replies to "@johnt15 @bjroc John, looks like I'm on the same track you completed. Do you know which..."
This is where I was in 2023 before I tried Tulsa Pro, nurse practitioner of one of the Mayo Rad Onc docs just kept saying on don't worry every time I asked to schedule me with proton. Then it became clear there were no appointments on their Hitachi Proton system available, but she was going to put me in a cyberknife kind of treatment. It was a big step down I felt, I had specifically seen him to do proton and they were just farming me off to lesser stuff.
I learned you have to look at Mayo a differing way, and it isn't critical of academics or the way medicine is done, Mayo is kind of unique in the world. So first priority are going to be high cash paying overseas fly-ins, from oil rich nations, or elsewhere, they pay super high cash. Second but close to first, are a study they got tons of money to run, and you fit exactly the middle of the study. Not on the edge of a study, you are like made for the study. Mayo gets lots from those grants, but they still bill your insurance, so like double pay for them. After that are basic Americans with BCBS or good Medicare plans, and who don't fit exactly the middle of a study we just need something soon, they don't have to do tons paperwork insurance preferred - but for them is single pay, one insurance payment basically.
It is just a reality. Even though I requested, wanted, really made it clear 100 times in 2023 that I wanted proton, they could not schedule me.
Not long ago they bought the Varian Probeam (very good proton system) since I was there anyway. So maybe it helps, but that priority list I have still may apply. Just be aware.
@dribbles
Sorry, but I don't know the machine they used nor was there any discussion on which machine I wanted. I just chose Short Term SBRT and they took it from there. I do remember them talking about how precise the radiation is. And through the research I've done and videos I've seen, the SpaceOAR virtually eliminates the risk of rectal burns. There are couple great videos on the PCRI website about how radiation has greatly improved over the past several years and the benefits of the SpaceOAR. Check them out.
As for not communicating directly with your doctor, I dealt with the Nurse more as well. But I did schedule a few virtual visits with Dr Brissom to discuss things and ask specific questions that I had prior to my treatment. He was great during those visits. I suspect yours will be as willing to do so as well. The virtual visit was the way to go for by eliminating the need to drive there.
Good Luck!
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@dribbles
I completed 5 sessions (WTFMT) with the Ethos machine. My 3 month blood test following the treatment showed undetectable PSA (started w/17 and G4/5 in two lesions). I also was on Orgovyx 1.5 months before the SBRT. My RO had access to an MRI Linac and chose to use the Ethos. I'm now off the Orgovyx and will test again late this summer. With the Ethos, I also had a SpaceOAR and fiducials inserted. That surgery was a breeze with no side effects and the side effects from the SBRT were gone within 2 weeks. By far, the anxiety was worse than the treatments.