What side effects have you experienced from SBRT for prostate cancer

This was what I intended to attach in the previous reply.

Thanks for input, unfortunately active surveillance is not an option for me. My PSA was eight in November and by February it jumped up to a 12
Wishing you the best

Welcome to the party. Maybe uncomfortable but from what I understand pay attention to diet, hydration and exercise. I need to do anyway.
My ride has been a little different. I went in for a bad cold Sept 2024...Dr had me do chest X-rays and being over 55 now, offered to do a routine PSA if wanted. Figured they were drawing blood anyway so may as well.
Next thing I knew I was scheduling a massive amount of Dr appointments and MRIs. After all the evaluations, I had to have a kidney removed with renal cell carcinoma and my prostate biopsy came back positive for Adenocarcinoma
Assessment/Plan
The patient is a 56 year old male with a diagnosis of a cT3a(on MRI)N0M0 prostate adenocarcinoma with a PSA of 9.09 and a Gleason Score of 7(4+3) in 4/4 cores right mid/apex. GS 7(3+4) in 2/2 cores right base and 4/4 cores from targeted lesion right base/mid. He had a R robotic assisted radical nephrectomy 1/8/25 for T1bR0 G2 RCC.

I explained to the patient that he has high risk prostate cancer. We discussed the various treatment approaches to prostate cancer including active surveillance, cryosurgery, radical prostatectomy, hormonal therapy alone, hormone therapy combined with EBRT and HDR brachytherapy.

I recommend external beam radiation with high-dose-rate interstitial brachytherapy boost with 1 year of androgen deprivation therapy. I would treat the prostate, seminal vesicles, and pelvic lymph nodes to a dose of 4400 cGy delivered in 20 fractions of 220 cGy each. This would be followed by a high-dose-rate brachytherapy boost for an additional 1500 cGy. I gave him the sheet with the next steps listed on it. I placed an order for a 45 mg Lupron injection which he can receive at his primary care physician's office. I placed an order for fiducials to be placed by urology
Next week I get markers placed and start all the radiation treatments...
Nervous isn't even the beginning of what I'm feeling...
The oncologist, urologist, surgeons and nurses at the Cancer Center of Colorado have been amazing and reassuring.
My heart is with you, hang in there. From what I understand this is curable as long as it stays out of the bone...
Everyone on the forum has also been super reassuring that this too shall pass. Do what the Dr tell us and keep in the fight.!!!!

My husband opted for robotic prostatectomy and recovered fantastically, however post op discovered it had already spread. It was then finally found 9 months later in a rib and he had SBRT on that with 3 sessions. Totally pain free and easy and had no issues post SBRT or localised pain in the area. CT scans now show the sclerosis on the rib (as expected) and the SBRT was successful . It’s very focussed and we were very impressed with the precision used.

I’m currently going through the decision of whether to have my prostrate removed or go with proton therapy. Gleason score of 4+3 biopsy shows 3 areas with cancer. PET Scan shows no signs of cancer elsewhere. Appreciate any comments

I was 3+4=7. Could have chosen any treatment. In choice selections, I was down to 2 . Brachytherapy or SBRT. Even though I believe Brachy is the better of the two, I chose SBRT. Because the expert for Brachy that I wanted to go to was in CA. I just finished SBRT this week. Before treatment I had 4 fiduciaries installed and a balloon. Not pleasant. My Dr chose the balloon over Spaceoar ? Side effects: Fatigue, Burning when urinating, inflamed rectum and triggered very angry hemorrhoids. 😡 I can say more, but I won’t. Not comfortable at this time. No ADT required at this time.

My husband (64 fit and healthy at diagnosis) was initially told Gleason 3+3 with a 15 mm lesion on outer edge of prostate but contained. Active surveillance was our health boards decision (in U.K.) as low grade cancer. 3 positive biopsies 1 from lesion area and 2 others from non lesion area all on one side of the prostate. He considered everything but decided he definitely didn’t want to opt for active surveillance as it would always been on his mind and he wanted to get rid of the cancer (Our brother in law was terminally ill at this stage with prostate cancer -he didn’t go to get checked until too late).

When we saw the surgeon we were informed he was never a suitable candidate for surveillance as the lesion was on the outer edge and bigger than 10mm. He had the op 7 weeks later (Dec 2024) and recovered fantastically, no incontinence etc. 7 weeks later we had post op check up and were told the lesion had grown to 34mm and extended outside the prostate and was regraded as 4+3 aggressive cribriform prostate cancer. The other 2 small lesions were low grade and deep in the centre of the prostate . We were devastated at hearing this but also pleased we’d ignored our health authorities advice and opted for surgery as the lesion had more than doubled in size in a matter of a few months.

Since Feb 2024 he had multiple CT, nuclear bone, mri and PETCT scans which were all negative!! None could locate where the cancer had metastasised however, his PSA was increasing at an exponential rate. Eventually his oncologist said hormone therapy (which he was reluctant to start) sometimes causes a spike which will show on a scan, so he had a 3 month injection which duly 3 weeks later showed the cancer on a rib. He had 3 sessions of SBRT on that rib last October and it was painless and easily tolerated and has done the trick. He absolutely hated being on the hormones (made much worse as he had such a great recovery from the operation), he felt terribly Ill and whilst understanding it can prolong your life, quality of life is often better than quantity. It’s taken 8 months for him to feel better again after the three month injection and his oncologist will try him on a newer hormone when he’s ready to try it again. He also needs angiogram’s now to check for angina as he had breathlessness on the hormones. Currently his PSA is rising again now and we will start the scanning process again soon.

Ultimately each person is unique and have to make their own decisions as to which treatment option they want to move forward with. We are both still very pleased that he opted for prostatectomy because it has the post op pathology of everything that has been removed which cannot be achieved by scans or biopsies. Goodness knows how bad a condition he would be in now if he’d opted for surveillance only.

I wish you all the best in your decision moving forward, I’ve only just found this forum and there’s a lot of information here to digest.

Best wishes and good luck.

Thanks for sharing your experience. I hope you are feeling better soon, from everyone’s responses on the post seems like the SEs are short term. Good Luck!
Everyone sharing their experiences has really helped me and I have decided to move forward with SBRT. Spacer placement is at the end of this month.

Thank you for wishing the best for those of us in this same journey as your husband. I also we ish you both the best possible outcome.
I myself has gone through SBRT from April 9 to 21. Been on ADT (Orgovyx) since March 26. My side effect symptoms have been mild so far, but I'm particularly watchful of this coming week in which my oncologist indicated my SEs might peak. I'm hopeful, but I'm also prepared whatever the "peak" is or will be. These things will pass.

You are correct. Side effects of ADT are generally much worse. Some have commited suicide on this S**T. ADT crushes what you were and can make you into shell of what you were before both mentally and physically.
SW