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Recently diagnosed
New to the forum. So I am planning to start treatment in the next month or 2. Most likely radiation. LDRT brachytherapy or SBRT. Anyone have brachytherapy done by DR Kurtzman out of Northern California. I guess he has treated over 7,000 patients. Like to get some feedback on him
Gleason 3+4=7. 30% of cores positive. 3 out of 10 cores. No extra capsular extension shown on MRI. Pirad 4 lesion which lead to my biopsy. However, mRI did state lesion is only 1 mm margin form neurovascular bundle. Which is not comforting
PSA 3.75 (last reading was early Dec)
The surgeon and RO I have meet with don’t seem to concerned about my cancer and say whatever treatment I have is fine. They say I should expect similar results. Really?
I want the best chance of cure with first course of treatment so really struggling with deciding on mono therapy or combo therapy (example brachytherapy plus external radiation).
Doctors say I just need monotherapy due to being stage 2 favorable intermediate but both of my parents died from cancer in their late 60s so I have the attitude of being more aggressive now. Father had Kidney cancer and mother breast cancer. I am 60
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A 3.75 PSA is nothing comparatively speaking. That’s why your doctors are telling you to chill. Strictly my subjective opinion as a stage IV patient myself. What I find annoying personally is there is very little if any and confusing information on average “survivability.”
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2 ReactionsIn addition to discussion with a urologist specializing in prostate cancer and a radiation oncologist, I found a 45 minute consultation with a urologic medical oncologist at the local Center of Excellence ( Fred Hutch in Seattle) to be very helpful in confirming my final decision for treatment (surgery n my case with numbers like yours.)
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2 ReactionsI did the same
Well I was similar to you. Had radical prostatectomy because I wanted to have benefit of pathology report and a second arrow in the quiver in case of reoccurrence. I did have reoccurrence and did SBRT salvage treatment it’s 4 months adt. May not have had bcr had I first chosen radiation. I will say radiation is much less invasive. That said I would repeat my decision again.
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1 ReactionDid you have PSMA pet scan? I had one node positive from surgery that didn’t show on mri or any pre surgical scans
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1 ReactionI am scheduled for a PSMA pet scan in 2 weeks. Doctor says I don’t need one but I insisted.
I am favoring either SBRT or low-dose brachytherapy seeds.
I met with a radiation oncologist at UCSF today he laid out all the radiation options. I guess they don’t do low-dose permanent seed bracky therapy at UCSF only high dose brachytherapy
If I go to UCSF, I’m leaning toward SBRT.
Although I’ve heard brachytherapy has as good results or maybe better as SBRT over 10 year period
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1 Reactionjarjib2: You might want to use your biopsy material for the Decipher test. Doctors do use this test to help them decide treatment. It shows the levels of aggressiveness and modes of treatments suggested. Whatever you decide, Spaceoar, Biogel or BioProtect will give space between the prostate and the rectum.
I had a narrow Margin (2 mm vs 3-5 mm for other forms of radiation) MRI real time guided linac radiation machine. I did not like fused images. I finished 5 hypo fractional doses last February.
Protect your healthy tissue. The more it is exposed, the more likely you will have side effects.
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