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Final decision on treatment: Viewray or Truebeam?

Posted by bl2023 @bl2023, May 29, 2023

Final decision on treatment: Viewray at UCLA or Truebeam at Kaiser
Well, after getting the word this last January 24 that I had G7(4+3), 3 lesions rt side, 1 lesion left side, and a Decipher low risk of 0.26, and rabbit holes of research and education, I’m close to deciding. I have to thank you on this and other forums for giving me your experience and insights. It’s really amazing to be able to talk to guys about their most personal details and struggles you’ve dealt with and I’m very grateful.

So. I’d like to hear from any and all that have any insights on their experiences with the above treatment options: Viewray vs. Truebeam. Bring it on.

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

drj | @drj | Dec 9, 2024

Yes. I was most impressed with him through his videos and was scheduled with him, but when a much earlier treatment became available with another doc, I chose the earlier treatment opportunity. I'm sure the doc I did end up with was equally capable based on my results so far (2 yrs along). The doc does play a key direct role in minimizing side effects (colon/rectum; bladder sphincter) and optimizing the result through the monitoring and control of each of the radiation sessions. Are they proposing the hydrogel pretreatment before the radiation? Good luck to you. Let me know if you have other questions in the future.

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Beachcomber20 | @itsaquarter23 | Dec 8, 2024
In reply to @drj "I went the same Viewray route as you but I'm one year behind you. My UCLA..." + (show)
@drj

I went the same Viewray route as you but I'm one year behind you. My UCLA radiation oncologist, Dr. Reddy, employed the hydrogel spacer because my large prostate was pressed against the prostate (the pre-/post hydrogel images were dramatic.) I suffered zero colorectal post-radiation effects as a result. Five treatments (around 30 minutes) in 10 days was an amazing process. Excellent staff.
My gleason 9 disease has responded well by all markers and tests.
Good luck.

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Would you recommend Reddy?

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Beachcomber20 | @itsaquarter23 | Dec 8, 2024
In reply to @bens1 "@ Beachcomber20 I have had no long term side effects so far." + (show)
@bens1

@ Beachcomber20 I have had no long term side effects so far.

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Great to hear!

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Beachcomber20 | @itsaquarter23 | Dec 8, 2024
In reply to @colleenyoung "@itsaquarter23 (beachcomber), I want to make sure you saw the reply from @bens1. How are you..." + (show)
@colleenyoung

@itsaquarter23 (beachcomber), I want to make sure you saw the reply from @bens1.
How are you doing in your treatment decisions?

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Still working on it.

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Moderator
Colleen Young, Connect Director | @colleenyoung | Dec 7, 2024
In reply to @bens1 "@ Beachcomber20 I have had no long term side effects so far." + (show)
@bens1

@ Beachcomber20 I have had no long term side effects so far.

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@itsaquarter23 (beachcomber), I want to make sure you saw the reply from @bens1.
How are you doing in your treatment decisions?

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1 reply
bens1 | @bens1 | Nov 30, 2024

@ Beachcomber20 I have had no long term side effects so far.

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2 replies
Beachcomber20 | @itsaquarter23 | Nov 30, 2024
In reply to @bens1 "Finished my MRIdian treatment in Orlando Cancer Center in February. 5 Treatments with spaceoar. NY Presbyterian/Cornell..." + (show)
@bens1

Finished my MRIdian treatment in Orlando Cancer Center in February. 5 Treatments with spaceoar. NY Presbyterian/Cornell Weill is doing a 1 treatment vs 5 clinical trial. 2 mm healthy tissue exposure vs 3-6 with Proton. Real time mapping with the built in MRI and dynamic mapping, if needed. Built in MRI is a big deal. It is more accurate than fusing images from other sources. Some urine restriction side effect but all good now. Looked at Proton at first as well. If Proton Therapy had a built in MRI and auto shutoff, I might have leaned in its direction.

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Now that's it's been awhile since your MRIdian treatment, how have your long-term side effects been from it?

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Beachcomber20 | @itsaquarter23 | Nov 30, 2024
In reply to @colleenyoung "@itsaquarter23, I'm tagging @mperloe to make sure he sees your post and questions about his experience...." + (show)
@colleenyoung

@itsaquarter23, I'm tagging @mperloe to make sure he sees your post and questions about his experience.

@itsaquarter23, did you make your decision about where to get treatment in the meantime?

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No, I haven't decided yet. I'd love to hear back from anyone who's been treated in Portland, Oregon, and can recommend specific radiation oncologists there.

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Moderator
Colleen Young, Connect Director | @colleenyoung | Nov 17, 2024
In reply to @itsaquarter23 "I'm also thinking about doing MR-Linac. It's now been more than a year since you've had..." + (show)
@itsaquarter23

I'm also thinking about doing MR-Linac. It's now been more than a year since you've had your treatment at UCLA. May I ask, how would you describe the short and long-term side effects? Also, any recurrence? I live in Portland, Oregon, and Providence Hospital here in Portland offers MR-Linac for prostate cancer. I'd prefer to be treated here in Portland, but the hospital isn't a center of excellence. It's just a community hospital. Do you think I'd be better off going to UCLA for the MR-Linac treatment? I'd appreciate any insights you can share. Hope you're doing well!

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@itsaquarter23, I'm tagging @mperloe to make sure he sees your post and questions about his experience.

@itsaquarter23, did you make your decision about where to get treatment in the meantime?

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1 reply
Beachcomber20 | @itsaquarter23 | Nov 7, 2024
In reply to @mperloe "I was 69 when my GL4+3 was discovered. I traveled from Atlanta to UCLA to get..." + (show)
@mperloe

I was 69 when my GL4+3 was discovered. I traveled from Atlanta to UCLA to get a PET scan which showed involvement just outside the gland in the seminal vesicle which didn't show up on MRI or CT scan. After speaking with a number of urologic oncologists and radiation oncologists I learned about ViewRay's MRIdian SBRT with Dr. Kishan at UCLA. I opted for this route as I was able to avoid fiducials and SpaceOAR. MRIdian offered automatic gating which shut off the beam should the rectum or bladder enter the beams path or the prostate move outside the treatment path. Neither proton or Truebeam offered that. While providers of proton therapy champion the Bragg effect, clinical trials have not shown proton superior to photon therapy or that it is associated with fewer side effects. Proton has just two beams vs 15 with MRIdian. This results in a higher risk of skin burns with proton treatment. In that the MIRAGE studies show a 40-60% reduction in early radiation side effects with MRIdian SBRT. And I never understood why someone would want to do 45 sessions when they can do just as well and possibly better with 5.

Dr. Kishan and the entire UCLA team made this an easy 2 weeks for 5 treatment sessions. I am now 2.5 years out from treatment and my PSA is undetectable.

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I'm also thinking about doing MR-Linac. It's now been more than a year since you've had your treatment at UCLA. May I ask, how would you describe the short and long-term side effects? Also, any recurrence? I live in Portland, Oregon, and Providence Hospital here in Portland offers MR-Linac for prostate cancer. I'd prefer to be treated here in Portland, but the hospital isn't a center of excellence. It's just a community hospital. Do you think I'd be better off going to UCLA for the MR-Linac treatment? I'd appreciate any insights you can share. Hope you're doing well!

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