Am I a candidate for SBRT?

Irondon55 · February 16

Hello. I am 68 with a recent biopsy detecting 5 samples (out of 12 total) showing Gleason of 6 and 1 sample showing 7 (3+4). My Urologist's referral was to a specialist within the same system that performs IBRT and that treatment is scheduled to start next month. However, on line researching suggests to me that I might be a candidate for SBRT. I would note that this health system does not have doctors performing SBRT (it is a small regional health system). I am in NE OH so close enough to the Cleveland Clinic and University Hospitals which both provide this treatment. I found recent literature suggesting SBRT is evidencing fewer side effects in addition to fewer treatments (perhaps 5 versus the 25 that they want to schedule). What I have not found is if there are other mitigating factors suggesting IBRT or SBRT is preferred based on the precise location of the cancer or other factors. So I am seriously considering getting a second opinion but wondering if I need to go back to my urologist to see if he can refer to another health system. Any comments are welcome. Thanks, Don

centralPA · February 17

Really, if you are near Cleveland Clinic, they are right at the very best in the nation. At a minimum get an opinion from them. No reason not to.

Clevelandguy · February 17

Hi,

Good advice from centralPA, Cleveland Clinic and UH are top notch. I had my Prostate removed at UH(Dr. Ponsky).

Dave 3+4

robcat · February 19

I was recently diagnosed with PC and was told it was low grade and had a Gleason score of 6 (3+3) on one of 14 core samples. Active Surveillance was recommended and in fact I've been on it since late 2022 because I was on blood thinners and couldn't have the biopsy until this January. I'm considering SBRT because I don't like the idea of having a malignancy and waiting for it to increase or grow. Has anyone gone through SBRT and can you speak to any of the after effects?

Afrnd2all · February 29

Robcat, I had SBERT back in Feb./Mar. of 2022. I had Gleason score of 7 (3+4) on one of 12 core samples. I was initially going to be put on Active Surveillance. But my Oncologist suggested getting a Decipher score for my tumor. It came back at a .67. Only side effect I had was getting tired. I hade 5 treatments, Monday/Wednesday/Friday on week one. And then Monday/Wednesday the following week. My PSA initially climbed over 3.5 points in a matter of months. My last checkup in Dec.'23 my PSA was .53.
Good Luck on your journey.

robcat · February 29

Thanks Afrnd2all. I'm scheduled for another PSA and then a meeting with my radiological oncologist. I'll ask about getting a Decipher Score in advance of SBRT. Neither the oncologist or urologist suggested getting the decipher score. I'll ask why.

Irondon55 · February 29

https://csn.cancer.org/discussion/comment/1713347#Comment_1713347

Thanks centralPA. Met with the (Cleveland Clinic) robotic removal specialist today and have an appt with their radiation oncologist later this month to evaluate the SBRT option. I am leaning towards SBRT if I am deemed a good candidate but will probably go with Cleveland Clinic regardless even though it is a bit longer drive. Relieved after visiting as the CC specialist said no immediate urgency to decide based on my profile. I felt as though my current doctor was pushing the schedule for IBRT to begin immediately. Next step is getting an MRI to get a volume, which may have bearing on which treatment makes the most sense.

Irondon55 · February 29

https://csn.cancer.org/discussion/comment/1713640#Comment_1713640

Also, I did talk to my original radiation oncologist who said he performs the shorter treatment span but "is conservative" and doesn't think there is enough data on this regimen to recommend. Most of what I am seeing in literature (and also on YouTube/UCLA medical prostate video series) suggests the higher dose SBRT it is at least as good as the lower dose regimen - in fact may have lower toxicity rates.

Old Salt · March 1

Yes, you are a candidate for SBRT. If you decide to go that route, find a center with a lot of experience in that therapy.

Old Salt · March 1

PS: I had SBRT at Georgetown U Medical Center. The ‘lead’ radiation oncologist has done well over 1000 procedures (Dr Collins).

Irondon55 · March 3

https://csn.cancer.org/discussion/comment/1713667#Comment_1713667

Thanks Old Salt. Did you have the shorter-higher dose treatment?

Old Salt · March 4

https://csn.cancer.org/discussion/comment/1713710#Comment_1713710

My situation at the time was different. My prostate had many Gleason 9 cancers and the radiation oncologist recommended a 'triplet' therapy. Three SBRT sessions + 20 IMRT sessions + ADT. Hence, the SBRT dose that was used is not applicable to your situation (with mostly Gleason 6 tumors).

robcat · March 6

Seeing my oncologist soon to make the decision on SBRT. Just wondering how sex was for those who had SBRT afterwards.

Arthurdent · March 14

Watch some YouTube videos done by the Prostate Cancer Research Institute. Alex and Dr. Scholz are very plain and straightforward in delivering information.

Generally speaking, they would rather see radiation therapy than surgery for the first treatment. Dr Scholz is an oncologist. Does not have a vested interest in either treatment method. They also have very good videos concerning side-effects of SBRT.

Good luck

robcat · March 14

Thanks. Will do.

Am I a candidate for SBRT?

Comments

Discussion Boards