Radiation @ 82 yrs old - 5 day or 5 week treatments?

I’ve never heard of the option of “20 week, 5 days a week.” The longest I’ve heard about is 9 weeks, 5 days a week (44 treatments actually).

> That also includes two years of hormone therapy, right? (That will impact your quality of life more than the external radiation.)

At 65y, I had 5.5 weeks, 5 days per week (28 treatments) of proton radiation 5 years ago; my oldest brother (79y) just had 5.5 weeks, 5 days per week (28 treatments) of photon radiation. We both tolerated our treatments very well.

The 5-day treatment (SBRT) increases the odds of urinary bother (due to so much radiation over a short course), but is usually well-tolerated and has similar outcomes as the longer protocols. Cyberknife and TruBeam are types of SBRT,

I’ve heard about the same results from people that have done 20 sessions going five days a week and those that get SBRT for five sessions Every other day. That’s what my brother did at 77 and he had small cribriform. He’s 80 now and doing fine.

Both groups Report some urinary issues. Those that I know of, had more of them with the 20 sessions. I had about 40 sessions 12 years ago and had no side effects at all. They give more radiation per session now, And it definitely causes more side effects.

I guess you can listen to other people on this forum and see what they think.

I have the same diagnosis (T3b) and the age is close (85). I had 20 fractions over 4 weeks with no side effects at all with EBRT. Lower dose helps I think. I'm 9 months post-radiation and still no side effects. That was a better choice for me.

@stew80 Yup, I had 25 over 5 weeks almost 2 yrs ago and even then there was talk of going down to 20.
Now that was for SRT, so I think for primary treatment they would definitely use a rectal gel spacer if it was gland defined. Best,
Phil

I would tend to trust your radiologist's advice. The two methods are radiologically equivalent. If you have lower urinary tract symptoms (your IPSS score) perhaps the 28x would be gentler, less likely to aggravate any existing problems.
Me: 28x EBRT/IGRT/VMAT, 4+3, mild (grade 1) urinary symptoms for a month

Similar age (80 at treatment) and similar diagnosis. I opted for 5 days, every other day preceded by a month of Orgovyx. The side effects immediately following the treatment weren't pleasant. I had a slight fever and diarrhea for about 10 days but each day the SEs lessened. I'm 6 months post treatment and feel fine. For me, the convenience of having the treatment done as quickly as possible was important and even with the side effects, I'd do it again.

I am a retired 81 year old Trauma Surgeon in UK. I did all the research on all form of treatment European and American papers before I decided. I
chose Cyber-knife, 5 treatments on alternate days for my Prostate CA. Five years on my PSA has always been . >0.01. Only problems weeing at night but I wanted to be continent, also constipation issues, easy to solve with diet and laxatives. My Prostate is cremated. 😊👍

I was Geason 8 at age 82 also. I had 44 radiation treatments followed by 4 months of Lupron shots. I had < 0.3 PSA and testosterone < 10 for 9 months after treatment ended. My problem has been really severe headaches, muscle pain, bone pain, joint pain, and the usual hot flashes and brain fog. My side effects are 24 hours per day and are just starting to subside after 14 months. If I had it to do over, I would try to go the pill route for ADT since Lupron dosage is so huge with a single shot and there is no way to stop it if it is excessive for you.

Just a wee comment. Please don't take this the wrong way. Any cancer is a nightmare and it wants to Kill you. My feelings is ANYTHING that can cremate your prostate is worth all the side effects for a longer life. I am happy with mine even though they are a bl**dy nuisance I know that I am still living. A rather nice feeling. Cheers and good luck

I was 59 when I had SBRT. 5 visits. What I was told was that 20 visits would be a bit “gentler”. But both RO’s felt that with cribiform that the higher dose would be more effective.
The PACE trials have shown excellent results for SBRT.
My biggest side effect was fatigue the 2nd week