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Calypso - IMRT Feedback Desired

T Paul
Posts: 12
Joined: Nov 2012

I am consulting Dr.s about my treatment options and learned of two radiation options.

Calypso external beam alone was one of the suggestions from CTCA. The other was LDR BT with 35 days of IMRT from RCOG. Naturally both Dr.s were confident of their approach and claimed each had it's benefits in regards to lower risks of side effects.

So I guess my request is at this point is if you have experience with Calypso or LDR BT w/ IMRT please share. Is Calypso alone strong enough? Is LDR w/ IMRT too much for my T1C with Gleason 7, PSA 1.8.

Thanks for the feedback.

T

Kristen123
Posts: 6
Joined: Jun 2012

Sorry to hear about your cancer. My husband completed IMRT in June. His was gleason 6 with psa of 7.8. He went through 45 treatments. It is definitely powerful. It killed the cancer and some surrounding tissue. His body is still recovering from tissue damage. My husband wishes he would have looked closer at brachy but choose IMRT. Its a tough decision. Like i said, the cancer is gone with recent PSA dropped down to 2. Its the side effects that you have to consider. Everyone's body handles things differently. I wish you well.

T Paul
Posts: 12
Joined: Nov 2012

Thank you for the feedback Kristen. Sounds likes your husband went through 45 IMRT treatments alone without brachy and the treatment was not Calypso? Could you confirm this please? I am looking at brachy plus 35 IMRT treatments as an option and am very concerned about being " overtreated ".

I am also considering Calypso alone without brachy with my concern being this may not be enough.

Thank you again for the insight.

T

Swingshiftworker
Posts: 634
Joined: Mar 2010

I know that it is offered (pushed?) by some clinics but IMHO you don't need to receive BOTH IMRT and LDR BT at the same time. One or the other should be sufficient and, if it isn't, you can always get a follow-up treatment w/the other method later.

FWIW, I think it's a scam to push both treatments simultaneously which enables the clinic (or doctor) to double bill for PCa treatment. Don't know if there are any controlled studies "proving" a significant increase in effectiveness of treatment using both vs one or the other, but that's something you should certainly ask to see if you are considering doing both.

Don't know anything about Calypso. IMRT and LDR BT are both widely used for PCa treatment w/a history of success.

Between IMRT and LDR BT, I personally would prefer IMRT because LDR BT requires the permanent placement of radioactive seeds in your prostate which will make you radioactive for the 1/2 life of the seeds, which is about a year during which time it is recommended that you keep your distance from pregnant women and young children and during which you will probably set off radiation detectors. The seeds will also always be an issue for you going through airport and other metal detectors.

However, IMRT is not without it's risks. Although it is widely used and generally avoids significant damage to collateral tissue -- like the bladder, urethra and rectum -- it is NOT as precise as other methods of EBRT (external beam radiation treatment) such as CyberKnife (CK) which is a form of SBRT (stereotactic beam radiation treatment) which IMHO is currently the MOST accurate method of EBRT currently available. Radiation w/CK is delivered w/sub mm accuracy in 3D/360 degrees and adjusts for body AND organ movement during treatment. Nothing else approaches this degree of accuracy with the comparable reduction in the risk of collateral tissue damage which is most often associated w/ED and incontinence.

As for BT, I also prefer HDR BT over LDR BT. The main reason is the HDR BT only places the seeds (in strings) in your prostate temporarily -- a day or so -- while the LDR seeds are placed in your prostate forever. On the other hand, the weakness of BOTH HDR and LDR BT is in the planning and placement of the distribution of the seeds. The incorrect planning and/or placement of the seeds can result in serious collateral tissue damage, resulting in the same effects as w/improper IMRT treatment -- ED, incontinence and rectal bleeding.

If you're not familiar w/the treatments and issues I've mentioned, take the time to reach
them for yourself. Your T1c and PSA readings give you time, although your Gleason 7 suggests that you shouldn't delay too long before choosing the treatment you decide is best for you.

Good luck!

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