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Need help deciding which radiation treatment system i should go with.
Hi. Recently diagnosed with PC. GL 7(3+4). PSA around 19. High intermediate group risk. Minimal extra capsular extension. PET shows no detectable metastasis. Been on Orgovyx since mid April, but for various reasons haven’t started RT.
I have choice of systems here and looking at TrueBeam as an accurate RT system. But I don’t think it has real time monitoring and adjustment for target position changes during a session. Also the radiation oncologist doesn’t think i need fiducials or hydrogel because he says system is so accurate. Without real time adjustments and no hydrogel and fiducials, is that basically ok to go with? Would CyberKnife be much better?
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I was 3+4 with a high Decipher score. Underwent 39 sessions of VMAT with the TrueBeam after having fiducials and SpaceOAR inserted. That was 2 years ago and I am now in remission. I had a single day a few months ago with some blood accompanying a bowel movement, but nothing since. No other side effects (I had ED before the treatment and still have it, though treatments suggested here have helped greatly with that).
On the other hand, I have a friend who was also treated using a TrueBeam linac at a different location. He had fewer sessions and did not have the SpaceOAR. He has suffered greatly from radiation proctitis and has undergone numerous procedures to stop his rectal bleeding.
If you choose the TrueBeam option, I would strongly encourage you to have a spacer implanted. Good luck.