Any experience w MRI-guided stereotactic adaptive radiotherapy SMART

Find a Radiation Oncologist. I had SBRT in the fall. 3+4 Gleason score. Worked well. Did have ADT for 3.5 months. First test 6 weeks ago showed PSA of < .04 and Testosterone at 167. No side effects.

I am also interested in MRI Guided SBRT for my early stage 3+4=7 in one of 12 cores. PSA 4.5. Looked into focal at Moffitt in Tampa but was told my lesion is too large (2cm). Radiologist suggested radiation. Does anyone know where in Florida they do MRI Guides SBRT? We have two Centers of Excellence in Moffitt and Mayo Jacksonville but Moffitt says they don’t do it. I’ve inquired to Mayo but have not yet heard. Thanks.

I had my treatment at the Orlando cancer center and they used the MRIdian linac for 5 treatments in February of 2023. They still use it but are going to buy the Elekta Unity which is a similar MRI based machine. I was happy with my experience.

Great. Congrats! So you are 2+ years removed from date of treatment- how was/is urinary, erectile, and bowel affect short term and how is it now? How is curative level? How was the recovery? Thx!

@tjp1958
My urination before treatment was slightly restricted and after the third treatment roughly 20% more so but I had a prescription for Flomax ahead of time and took it right after the third treatment. Overnight, my flow was stronger. After 6 months my flow was almost better than when I went in for treatment, even though my doctor said don’t expect it to be better than when I went in.

Erections and orgasm’s were less intense but still occurred shortly after treatment and still do today. The erection is not as hard but it is decent.

I had no pain whatsoever and no bleeding from the rectum. I had spaceoar and of course, the MRIdian allowed for 2 mm margins, instead of 3-5 mm for other types of radiation, so less healthy tissue exposure meant less side effects.

My PSA started at 11.2 before treatment and mostly, steadily declined to .75 as of May 2025. I had 2 small rises but my RO said that if my PSA rose 2 points she would be concerned. She said if it rose 1 point she would do a psma pet scan.

Thx! Did you use an ED med before radiation? After? Any help in hardness? Intensity?

@bens1 Was it Orlando Health MD Cancer or was it Advent Health Cancer? I’m in Orlando as well. If you would recommend using the same could you please share your Drs name with me? You can DM me direct (if that’s possible) if you don’t want to go public with it.

@tjp1958
I did not need any medication for that at all. I did not take any blue pills and never have. The hardness and the erection was good enough so no medication was necessary.

@ucfron

I have no problem sharing at all as I think she saved my life. Her name is Dr. Kaitlin Christopherson. She is at Orlando Health/Orlando Cancer Center. She was trained at MD Anderson. She has one of those personalities that allowed me to drill down and ask a bunch of questions without annoying her. She answered my questions directly and if she did not know the answer for something that was out of her Area of expertise, she would say so. I was lucky to have found her and she was the fifth radiation oncologist that I spoke with.

I’ve heard and read her name before. Thank you.