5 treatment radiation

Posted by rice @rice, Sep 26 9:38pm

Hi I am 72 , I had a prostate biopsy of 15 cores 1 core had less the 5% 3=4 T2. I sent it to Dr Epstein He change it the 3+3 T2. I have been watching it for one year my last biopsy did not show anything. I was doing a follow up with my radiologist, I told him I did not like biopsys. He told me If I wanted to he could do 5 treatments no follow up HT. the only side effect possible ED years down the road. MY concern it If I do this what are the chances of it coming back and how would it be treated.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Rice: I had the mridian linac in Febuary instead of proton. 5 hypo fractional Treatments. The mridian combines real time MRI with photon radiation that has auto shutoff, real time mapping (vs fused images), dynamic mapping and 2 mm margins instead of 3-6 mm margins. No ADT. I did compare it to Proton and many on this site would do Proton again if they had to. It was my second choice.

My PSA started at 10.29 on 10/5/2022 . Gleason 3+4. Cancer contained to prostate. Three blood tests since February.: 3/31/2023 psa of 4.61, 5/25/2023 psa of 2.99 and 9/12/2023 psa of 1.4.

Doctors sometimes use the word cured but my perspective is that every 3-4 months when I have a blood test, I assume it could start again but am always hopeful it doesn't. My life is in monitoring mode which I am thankful for and I get to be active.

Make sure you check out the type of radiation machine and the margins that are used as it impacts healthy tissue and therefore side effects. Get more than one opinion.


@rice, here are some related discussions you may be interested in:
– Radiation with or without ADT
– Is ED after radiation without ADT permanent?
– Photon Stereotactic Body Radiation Therapy (SBRT)
– How did you choose between proton or photon radiation?


My question is given the clinical data, why would you treat?

There are other ways to determine any PCa activity in the prostate – https://www.cancerresearchuk.org/about-cancer/tests-and-scans/multiparametric-mri#:~:text=A%20multiparametric%20MRI%20(mpMRI)%20is,that%20you%20have%20prostate%20cancer.

As to your first question, the chance of it coming back, good question, I doubt anyone can say definitively. if they do, throw the BS penalty flag. At best they can throw historical and population based data at you but your PCa is not theirs..,

The 2nd question, what would then the treatment be, nobody should answer that because if it comes back, when it it does, clinical data and advances in treatment methods that we don't know now will be factors in that decision.

As to the ED, I've had three separate radiation treatments, SRT was the first one, no ED.


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