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SBRT-Cyberknive with HT

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Posted 8/29/2018 10:26 AM (GMT -5)
Hi guys.....Well I’m into the 60th day after Dx and still have not made up my mind on treatment. I have done the biopsy, Ct , bone scan and coiled MRI. I have been offered the following: RALP with clinical trial of taking Casodex for 6 mos prior. eBRT + ADT 4-6 mos with IMRT/IGRT/VMAT to sem vesicles and LN. (7560/8100 cGy)
I am now looking at SBRT with HT as an alternative. Going to BCM tomorrow in Houston for an assessment.

Present risk strat is cT3a due to finding ECE on the MRI.

I will welcome any thoughts from people who have done this treatment.
Posted 8/29/2018 10:46 AM (GMT -5)
Sorry my bio info does not appear.

Biopsy done 6-17-18 CT scan bone scan both Neg.
Stage cT2c R. Lobe: G 3+4/7 Rightbase neg. right mid showing Ptc in 1 of 2 cores (10% of biopsy volume)
And r. Apex showing 1of 2 cores and (less than 5% of biopsy volume. left lobe:G 4+3/.Left base showing PTc in 2 of 2 cores occupying 90% of P.volume with PNI. left mid showing pos. In 2of 2 cores occupying 60% of biopsy vol. PSA 4.9 night/ml
Coiled MRI done at MDA on 8-16-18. There is extracapsular extension. The tumor abuts the left puborectalis muscle. The neurovascular bundle is not involved., no pelvic or inguinal adenopathy , no seminal vesicles involved. Risk strat raised to cT 3a after MRI.

Post Edited (BangedUp) : 9/24/2018 8:29:19 AM (GMT-6)

Posted 8/29/2018 11:01 AM (GMT -5)
I hear good things about SBRT. I think you'd be happy with that choice. It avoids the trauma of surgery, it's only 5 treatments and long term SEs are reported as low.

Plus it's curative with a high likelihood of be a one and done treatment.

Do check it out.
Andrew
Posted 8/29/2018 2:49 PM (GMT -5)
There is no evidence that adding HT increases the effectiveness of SBRT.
Posted 8/31/2018 5:01 PM (GMT -5)
Well I met with CyberKnife doc at BCM in Houston....I am disappointed....They can only offer 5 weeks of Ebrt with HT and a 2 day Cyberknive boost....I just don’t know how this would compare to my orig 7 wks of ebrt( IGRT/VMAT) and ADT.....done by my local RO.

I guess with my ECE ....my choices are limited.

Has anyone had this experience?
Posted 8/31/2018 5:41 PM (GMT -5)
ECE doesn't preclude EBRT - it treats the cancer wherever it is. My RO treats guys with ECE with 5 SBRT treatments. You may have to leave Houston for it.
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