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Emory Winship - HDR BT after 4th consultation. Thoughts?

T Paul
Posts: 12
Joined: Nov 2012

After 4 consultations and discussions of RP, IMRT Calypso alone, and LDR w/ BT I am almost sure I will go the HDR BT route with St. Joseph/Emory Winship Cancer Center in Atlanta Ga.

While the previous consultations were informative and treatments were discussed or suggested, I felt the discussions with the Dr. at St Joe were far more open to what was best for me and not their specialty.

This shared I would appreciate any insight on HDR BT and St. Joe/Emory.

Best,

T

VascodaGama's picture
VascodaGama
Posts: 1519
Joined: Nov 2010

Confidence is a big “step” forward for the success of a treatment. Independently of your reasons in the choices, HDR BT got proven successes in terms of survival free rates among RT modalities. Its data has served to set standards in radiation treatments, not just with regards to Gray intensity but in terms of acceptable side effects.
Of course, the quality of the facilities and the team of professionals delivering the treatment is an important issue in the overall outcome.

Here is a link of findings from PCRSG;
http://www.prostatecancertreatmentcenter.com/ProstateCancer/ProstateCancerResultsStudyGroup.aspx

I wish that you manage to give a blow to the bandit and put it down on the canvas forever.

Good luck in you journey.

VG

Swingshiftworker
Posts: 620
Joined: Mar 2010

Of the treatments you've mentioned, I think that HDR BT is your best option.

The only downside to HDR BT is the manual and fixed placement of the seeds and the radiation plan based on that placement. If the placement is incorrect, you still have a significant risk of collateral tissue damage to your urethra, bladder and/or rectum, which can result in ED, incontinence and other problems.

One other option you didn't mention is CyberKnife (CK) which is a form of stereotatic body radiation therapy (SBRT) which I consider the best available method of treatment for PCa currently available.

CK is, in fact modeled after HDR BT, but the key difference is that the administration of the radiation is controlled by a computer program which directs a robotic arm that can deliver radiation to the prostate in varying amounts in 100's if not 1000' of different directions in 3 dimensions (360 degrees) with sub-mm accuracy AND can adjust for body and organ movement during treatment. With HDR BT or any other radiation method, internal organ movement can affect the amount of radiation delivered to the target area significantly and can result in collateral tissue damage as a result.

So, if you're open to looking further, I'd suggest that you investigate CK as another option.

Good luck!

mrdezzy
Posts: 23
Joined: Mar 2012

Do you have recommendations on locations for the cyberknife with the most successfu experience..I am in the same boat...thanks

Swingshiftworker
Posts: 620
Joined: Mar 2010

You can find CK locations by using this page which is sponsored by Accuray, the maker of CK: http://cyberknife.com/CyberKnifeLocations.aspx.

You can also find out a lot of other info about CK by clicking on the various links in the sidebar on the Locations page.

mrdezzy
Posts: 23
Joined: Mar 2012

great, thanks swingshiftworker, where did you get your CK treatment and would you recommend them?

Swingshiftworker
Posts: 620
Joined: Mar 2010

I was treated at the UCSF Medical Center by Dr. Alexander Gottschalk, who is the Director of the CyberKnife at the Helen Diller Family Comprehensive Cancer Center.

See: http://radonc.ucsf.edu/faculty/physicians/gottschalk_a.html

I highly recommend UCSF Med Center and Dr. Gottschalk. UCSF accepts CA Blue Shield for the treatment of PCa w/CK and I didn't have to pay a cent for my treatment, any of my followup PSA tests or for the recent MRI/MRSI scan to determine if the cancer had returned or not -- it did not.

mrdezzy
Posts: 23
Joined: Mar 2012

Thanks for your reply and information. Happy to hear of your success, I really cant understand the lack of insurance coverage for this procedure, seems to be patient convenient, cost effective and has good results...I understand the concern about 5 years data, but I think there would be some issues develop in less time than that if there was anything seriously deficient in the therapy. Just my thoughts as a guy exploring treatment options.

Swingshiftworker
Posts: 620
Joined: Mar 2010

There are insurers that do cover CK and other more recently developed radiation methods, like proton bean therapy (PBT). However, each carrier makes its own decision about that and, even under Blue Cross/Blue Shield, you will find some carrier that do and do not cover the treatment.

The only thing you can do is shop the coverage (if you have the luxury of choosing a carrier) or make an appeal to your State Insurance Commissioner if coverage is denied. I have a paper (somewhere) from CA Blue Shield which supports its decision to begin offering coverage for CK which could be useful in making such an appeal. Let me know if you need it and I'll try to find it.

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