MRIdian Viewray Experience

Posted by bens1 @bens1, Feb 2, 2023

Making a decision related to which radiation machine one uses seems to be something that does not get a lot of discussion by urologists and radiation oncologists in terms of the differences, other than their success with the machine they use. I chose the MRIdian Viewray. There are multiple choices with different capability and toxicity risks.

I had my first treatment, out of 5, on January 31. I had spaceoar gel inserted. The machine is both a radiation and MRI built into one unit. They can see healthy tissue and the cancer in real time and adjust accordingly using the machines dynamic mapping capability, if necessary. They used 2 mm margins based on a recent randomized trial called Mirage. The machine turns off automatically if your internals move and the radiation goes outside the mapped out area. No pain or real side effects after the first treatment. Second treatment is on Friday. My prostate cancer is contained within the prostate and I am almost 70 with Gleason 3+4 on one core and 3+3 on another. Psa was 10.2.

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

@eaafedt1

@bl2023 do you live in California? I am finding some hurdles to Dr Kishan as I live out of state.

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No. Had to travel to CA, but felt it was worth it.

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In your post you said "The machine turns off automatically if your internals move and the radiation goes outside the mapped out area." What I want to know is when the photon radiation is being given, is it able to pass thru the tumor and then exit the patient"s body?" Or is it totally confined within the tumor because the mapped area wraps all around the tumor? Also, what did your PSA finally go down to?

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@msciulli

Did this at UCLA with Dr. Kishan. So far no SE. Only time will tell when I get scans and PSA tested after off ADT.

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https://connect.mayoclinic.org/member/00-a205347baa758df3288741/
How are you doing now several months post MRIdian with Dr. Kishan? I am curious what your stats were why you needed ADT therapy? Thanks for the post.

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@msciulli

No. Had to travel to CA, but felt it was worth it.

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Thank you for your helpful posts. I would love to know how you are doing now?

I am in New Orleans, but willing to travel to find the best, most experienced MRIdian team and treatment. Also, have traditional Medicare which hopefully covers the procedure. I would welcome your thoughts on where to go, doctors, etc. Lots of videos on YouTube with Dr. Kishan, but not RO. Did you get SpaceOar and ADT therapy? I appreciate this community and open discussions. Thank you.

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@ftd3

Thank you for your helpful posts. I would love to know how you are doing now?

I am in New Orleans, but willing to travel to find the best, most experienced MRIdian team and treatment. Also, have traditional Medicare which hopefully covers the procedure. I would welcome your thoughts on where to go, doctors, etc. Lots of videos on YouTube with Dr. Kishan, but not RO. Did you get SpaceOar and ADT therapy? I appreciate this community and open discussions. Thank you.

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Ftd3: i was happy with my MRIdian team in Orlando but Dr Nagar at NY Colombian Presbyterian/Weill Cornell focuses more on the prostate than any of the 5 RO’s that I spoke with who were all using the MRIdian machine. My brother also was treated by him on the mridian. My treatments ended in February and my psa has gone down in the last two tests since then.

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@bens1

Ftd3: i was happy with my MRIdian team in Orlando but Dr Nagar at NY Colombian Presbyterian/Weill Cornell focuses more on the prostate than any of the 5 RO’s that I spoke with who were all using the MRIdian machine. My brother also was treated by him on the mridian. My treatments ended in February and my psa has gone down in the last two tests since then.

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Thank you very much for the kind reply and your comments. I do appreciate hearing from you. I am just starting to research MRIdian, who has the most experience and the best team with a focus on the prostate. How are you and your brother doing as far as side effects and recovery from the radiation?

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Both my brothers and my experience with the Mridian was great. He also had to be put on Lupron but before he started getting those injections, his side effects from radiation were basically the same as mine. I had some restriction in urinating, but I expected that and my doctor had written a prescription before radiation for Flomax. She said take the low dosage that she prescribed and within a day my flow improved, I am off Flomax for more than a month now. I took a few more afternoon naps but other than that there were no side effects. I did have Spaceoar inserted, and that gave me an extra half an inch of protection between the prostate and the rectum.The MRIDian uses 2 mm margins versus 4 to 6 mm for margins on every other machine, including Proton . Protecting healthy tissue that impacts quality of life was a priority for me.

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Good to hear from you and happy to hear you all had such good experiences with the MRIdian treatment. I really wish to avoid Lupron or any ADT therapy due to the side effects. Wonder if you know or if your doctor gave you the stats regarding how you would do with or without ADT? No issues with the SpaceOar? I agree with you protecting healthy tissue is #1 and quality of life. I've got BPH with a really large prostate at 123cc and enough urgency and frequency issues even with BPH rx 10mg Uroxatral. I may need to look into Flomax just concerned about side effects. Thank you sir! Happy 4th!

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Ftd3;i had no issues with spaceoar which was inserted rectally. Your prostate size may be worth discussing in terms of type of treatment.

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Could you please answer my posted question about the chances of photon radiation exiting the tumor using the Viewray MRIdian system? Is this eliminated/reduced as a result of the "mapping process"? Thanks

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