Posted 12/30/2017 1:03 PM (GMT -5)
Hi three 5's,
Thanks for your note. So, far I am doing well during the SBRT treatments completing 4 with my 5th and final on Tuesday Jan 2. After that final treatment I will write a summary of my experiences during treatment including SE.
Hi Suttersmill,
I want to answer your questions. My primary Urologist (after firing 2 others I did not like) is Brian Miles at Methodist in Houston. He is one of the most experienced Urologist in Houston and is still very active doing surgeries in his 70's (done more than 3000). I knew I did not want to go the surgery route. I worked at going on Active Survellence (AS) since my Gleason was (3+3) =6 but to make a long story short in consulatation with different doctors including a reputable Prostate Oncologist I was discouraged because I had two large lesions, one in each lobe, and one either right next to the capsule or probably already into the capsule depending on which Radilogist you want to believe but neither is good. The DRE also indicated irregularity. I also had a lot of the Gleason (3+3) =6 in the lesions and outside the lesions which increases the probability that there are higher grade cells.
I did consider going to M D Anderson but rather than elaborate on that the information I could find out was they did not do SBRT on the prostate though they do it on other cancers - it seems likely they will start using SBRT on the prostate in the future if they have not already started. I did meet with a very experienced Radiologist (Dr. Steve Carpenter) at St Lukes Health in Houston (that is also affiliated with Methodist) who used SBRT on the prostate but he had not done very many and had no record of success or SE on those he had done. So, then I started investigating UTSW and found they had done SBRT for many years and had a very active program for this treatment with good success and a wide range of experience. My doctor (RO) is Dr. Raquibil Hannan who is very experienced in the SBRT treatment and he politely answers questions but other than answer questions he does not volunteer a lot of information. When I first met with him he thought I should consider AS and offered that he believed UTSW could do a better job on my mpMRI including interpretation and suggested genetic profiling but by then I told him I had pretty much made up my mind to get treated by SBRT and at a second discussion with him he said he thought it was a good proper choice for me otherwise he would not agree to do it. They do use a SBRT treatment of 45 gy (most institutions are using 36 - 40 Gy) as a standard because they believe it gives better results to eradicate the cancer with no worse SE and credit using the gel spacer for rectum protection that helps them achieve added protection for the rectum. The best or higherst level of total treatment radiation to the prostate without excessive SE is debated and most of the SE danger is how well the radiation is controlled around the prostate - not the total to the prostate itself. I got comfortable with doing the 45 gY standard treatment at UTSW because they have alot of expereince with it and have a great team environment of doctors and radiation therapists and it is not just one doctor or person making this type of decision.
If I can answer any more questions let me know and you can find my email in my profile.