For those who chose SBRT

sheepguy - I'm one of the SBRT "groupies." I am not a zealot, but I do question the value of research studies that may or may not have studied radiation treatment and its results from 15 years ago (or longer). Much like so many other medical treatments, if we wait for long-term efficacy studies for every treatment, we are doomed to never have the benefit of the newer technologies. By the time the long-term studies are available, three generations of newer technology is out there and the one that was so laboriously studied is long obsolete.

If we were all counseled to wait for long-term study results, we would still only have open surgery and brachy to depend upon. All of the others are relative newcomers.

Trust me. . . I'm never going to look back and second-guess my choice.

I'd be interested in reading about how the ultrasound works compared to fiducials. Kind of a moot point for me, as I already have fiducials and have completed treatment. I'm just fascinated with all the technology in use.

I'm not surprised about their moving away from the spacer gel. From the study that TA linked a while back, the gel didn't make enough of a difference to be worth the cost and discomfort of yet another invasive procedure.

I guess I might have wished for a way not to need the fiducials, but in hindsight (pun accepted), it was only uncomfortable while they were inserting them. 10 minutes later, no pain or after-effects. As long as my PSA does what it is now supposed to do, I'm a happy camper.

Oh, and I am all too familiar with how some doctors advise you based upon their opinions, rather than trying to look at all of your facts and the up-to-date data and research. Most of the time, they are probably right enough. But in the case of my personal medical care, and when the treatment choices could have very long-lasting implications, I tend to get a bit more "involved."

Yes,Inquisitive1 and Stevein Erie,lifestyle choices.LDB was high on my list.My new born grand-daughter was on my mind.Dr.Moran,world class downplayed the toxicity of LDB but why chance it.Thats just me.As you know I chose SBRT.HDB came in second and seeds 3rd.Its a really individual decision.Dr.Moran also wanted to do 25 session of IMRT before the seeds.I thought why not 5 zaps with SBRT,9 yr. study.Good Luck.

steveinErie said...
But I can't discount advice from the CC either.

Just checking, steve - when you talked with folks at CC, were they the CC-SBRT guys? If not, I'd suggest you also include their input. CC is getting into SBRT for PCa in a big way now, if I'm to believe their web site.

As you all know, I am a believer in the experience of a doctor who deals directly with patients and their treatments as opposed to google docs who have little direct experience with anything but their own case and their research. It's just not the same in my view. Sure "shared decision making" is a good idea, but I don't know that the patient should be calling the shots. Call it paternalistic if you want, but it is the rare patient that knows more about the specifics of any case than an MD..not the consensus around here, but that's just me. ...and I know as much as I need to as a layman about the disease.

Mel - That sounds exactly like my parents. Sadly, that didn't work out well for them. They died far sooner than I feel they had to, but they were confident in their doctors. (I wasn't, but have you ever tried to change your parents' minds?)

sheepguy - To each, his own. I'm one of the guys who wouldn't be around here (to torment you?) if I hadn't taken a very active role in my own medical care when I was having cardiac issues. Doctors know what they know, but they, like any of us, don't always know (or admit) what they don't know. If I am not comfortable with what they tell me, it is my responsibility to go elsewhere until I am satisfied that the information I am getting is reliable. I have to "own" it. If I make a choice from the range of options offered by doctors, then I must live with the consequences of that choice. I'm fine with that. I just don't do well if a doctor says "This is what you must do" and it doesn't go well. I have to be part of the choice, as long as I am lucid and capable. That's just me.

If you use the term "Google Docs" to mean the members here, I agree. My opinions are worth every cent you've paid for them. No problem there. If, however, by Google Doc you mean a specialist I needed to use Google to find, then I would have to disagree. There are so few of some of these specialists, one would have to hunt for a long time to find them. In one case, I saw or spoke with 5 docs AND used various internet sites to finally get a recommendation to see a 6th one. I don't see anything wrong with that.

I could go on and on, but since I really don't know if we're agreeing or disagreeing, I'll just stop here.

I'm not advocating one way or the other,just giving my personal position,which does not preclude being well informed. I can read scientific papers as well as anyone and am well aware that they don't always tell the whole story and know where to find them. You just need to go with what makes you comfortable. but believing your doctor doesn't mean you are a simple minded idiot trying to kill yourself.

Sheep:

>>>>>>>>>>>>>>>>
but believing your doctor doesn't mean you are a simple minded idiot trying to kill yourself.
>>>>>>>>>>>>>>>>>>>
Nobody is saying that. Not at all.

Then again, the poor shmuck with the small-volume G6 whose urologist is urging him to get that surgery quickly ...... well... it would be quite beneficial if he discovers HW...in time!

Mel

Personally I prefer Mel's schmuck analysis/examples over Sheep's...

And,

Jim

So if you believe your doctor he is at the bottom 10% of his class?

steveinErie - My hubby had long standing BPH to contend with along with his PCa. At each of the different cancer center consults we attended they had his record of his BPH and had his IPSS number from that day in front of them and still 2 of the known cancer centers did not take it into as much consideration as MSKCC did where the doctor explained to us why my hubby was not a good candidate for seeds right off the bat. At one of the CCs, with the RO holding the IPSS and BPH history in front of him, he still was pushing seeds. It took us reminding him about the BPH and how we thought that seeds might worsen an already unstable urinary flow before he backed down and said oh yes of course. I just think you gotta be careful and be your own advocate. Things may have gotten pretty uncomfortable for my hubby if we followed his advice. We were taught here very well to have your questions ready and to read, read, and read some more.

Good info InquisitiveOne. Thank you. I wish the best to you and your hubby.