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Considering Tulsa Pro or Proton radiation (full gland)
Prostate Cancer | Last Active: 1 day ago | Replies (101)Comment receiving replies
@jaygk I just had a TULSA consult from the one group that does it here in St. Louis. They’ve conducted about 70 procedures, which honestly didn’t sound like a lot to me. I’m 58 (so on the younger side for all of this) and G7 (3+4) but with some cribiform and cores with around 50% 4. I’m intermediate risk, but one urologist considered me unfavorable. Most docs seem to think I’m right in the middle of favorable and unfavorable because of the cribiform and amount of 4. PSMA PET did not show any spread. My PC is primarily on the left side, but there is also some on the right, so I would need whole gland treatment.
The TULSA doc said they would be willing to treat me, if I understood the risk of recurrence. I believe that was primarily because of the need to treat the whole gland and my relatively young age (it’s nice to be considered young somewhere!). It sounded like he would be more optimistic about TULSA for me if I were older since the data only goes back a few years.
I’m not sure, but am guessing that’s why Medicare readily covers TULSA (older patient population), but private insurance is iffy (generally younger patients).
Needless to say, that didn’t give me the warm fuzzies I was looking for, so I’ve ruled out TULSA for myself. Still glad I did the consult, and appreciate the doc’s candor. I’m waiting on prostox results ordered by a RO at Siteman Cancer Center, but am leaning towards SBRT, or possibly brachy.
Hope this helps. All the best to you in this very confusing decision-making process.
Replies to "@jaygk I just had a TULSA consult from the one group that does it here in..."
@stldadof4 that sounds very similar to my experiences at Kettering for Tulsa.
I wasn’t sure if it was my whole gland or my less than 5% Gleason 5 that made me unfavorable. I think they would do the treatment if I insisted …. but they felt I would be back in 2 to 3 years to be retreated.
I received my decipher test back and got a 0.19 which I am excited about.
I’m sending my Gleeson five off to Dr. Epstein for a second opinion.
If my 5 is downgraded to 4 I will probably skip the hormone therapy based on that fact, and my favorable Decipher score
I just sent my Prostox off to see if I’m sensitive to radiation.
If I’m not sensitive, I’m looking at 28 IMRT treatments at the university of Cincinnati
28 is a lot but the radiologist oncologist mentioned that the SBRT can be somewhat of a roller coaster and I am only 20 miles away from the site
I’ve never been through anything in my life that was so difficult to decide.
So many options and so many side effects.
I hope I can be confident in my decision and not second-guess myself after treatment begins
I have requested the spacer and the gold markers
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@stldadof4
Hello,
I’m one of the 70 cases preformed in St. Louis if you’re talking about SLU/SSM. I got the same caution about cancer possibly returning. My thinking was if it returns I’ll look into radiation or surgery, but the relative ease of TULSA PRO made it a no brainer in my mind. I’m 69 so there was no issue with coverage from my insurance company. In fact, to my surprise, the procedure did not require pre approval.
I had a G7 (4+3), cribform and 17 out of 20 samples from my prostate had cancer. The cancer had started to encroach into my bladder space, but the prostate sac was still intact. I had planned to undergo radiation with a previous doctor, but found TULSA PRO a week before the placement of gold seeds in my prostate for radiation treatments.
Good luck with your decision.