SBRT vs. Robot-assisted radical prostatectomy

Posted by dandl48 Dave @dandl48, Jun 11, 2020

Well, my last visit to Mayo didn’t go as well as I wanted. I’m 72 years old and I had an Ultrasound-guided transperineal prostate biopsy and the results came back positive for cancer with a Gleason score of 4-3=7 and the Grade Group of 3 which is a Risk Group of Intermediate Unfavorable. With these results active surveillance is out and it’s either radiation or radical prostatectomy . If I choose radiation SBRT is available to me using protons for 5 treatments over a 10 day period. The downside of this treatment is I will have to have a 4 month Lupron injection before radiation and that if the cancer returns removal of the prostate would probably off the table. Choosing the radical prostatectomy which would be robot assisted, comes with its own problems, infection, incontinence and impotence. Decisions, decisions, I’m open for your input.

Thanks, Dave

@horace1818 wow, that's something I hadn't heard. All the people I've talked/chatted with said the opposite.

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I had surgery at age 67. Talked to medical, surgical and radiation oncologist and got input from each. Gleason 9 I chose surgery. 3 months after I was setting up adjuvant radiation at suggestion of surgeon. Long story, but bladder incontinence is terrible and still is.. I was told by radiation oncologist at another institution when I was talking to Doctors about the adjuvant radiation that he thought the gold standard for G9 was hormone therapy and radiation at the start. With radiation surgery, as I understand it, follow up surgery is difficult. This was several years ago so things may have changed. Just my two cents worth.

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Well, first of all I want to thank each of you who responded to the question. My decision has been made and I will be going for the SBRT 5 treatment over 10 days at Mayo Rochester. Did a ton of reading, bothered the heck out of the 2 Drs, (radiation & Surgery) and praying. Will be starting the Hormone shot next month and will be going to Mayo in 3 months if all goes smoothly.
Thanks again

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@dandl48

Well, first of all I want to thank each of you who responded to the question. My decision has been made and I will be going for the SBRT 5 treatment over 10 days at Mayo Rochester. Did a ton of reading, bothered the heck out of the 2 Drs, (radiation & Surgery) and praying. Will be starting the Hormone shot next month and will be going to Mayo in 3 months if all goes smoothly.
Thanks again

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Excellent decision. Glad you did all the research. Best wishes for smooth sailing with your treatment plan.

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@dandl48

Well, first of all I want to thank each of you who responded to the question. My decision has been made and I will be going for the SBRT 5 treatment over 10 days at Mayo Rochester. Did a ton of reading, bothered the heck out of the 2 Drs, (radiation & Surgery) and praying. Will be starting the Hormone shot next month and will be going to Mayo in 3 months if all goes smoothly.
Thanks again

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Good luck! SBRT/PBT?

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@cmartin65

Good luck! SBRT/PBT?

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@cmartin65 SBRT done with a Proton Beam

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@dandl48

@cmartin65 SBRT done with a Proton Beam

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That's my plan also at Mayo! I'm still debating 5 vs 20 treatments!

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@cmartin65 UCLA came out with a good study. They have been doing it since 12/2000. Don't know if posting a link is permitted, but here it is; https://www.uclahealth.org/radonc/prostate-cancer-sbrt

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EXCELLENT summary. One of the best I've seen. Thanks for sharing.

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@dandl48

@cmartin65 UCLA came out with a good study. They have been doing it since 12/2000. Don't know if posting a link is permitted, but here it is; https://www.uclahealth.org/radonc/prostate-cancer-sbrt

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Very good link! Thanks!

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Well, will be traveling to Mayo over the Labor Day weekend, 2,200 miles one way, and will be starting the tests and implanting the markers into the prostate for aiming the SBRT machine. In addition DR's will be giving me an endoscopy for my Barrett's and also looking at my liver, believe it or not a liver can develop High blood pressure, go figure. All in all I'll be out there for 30 days. Wouldn't fly these days if it were a free flight.

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I admire your commitment to the treatment regimen and respect your decision to stay safe from Covid 19 by driving to Mayo. Long journey, but I'm sure you'll see a successful outcome in the end. Worth it . . . !

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