Hi all
I’d value your help to help me make my treatment decision as I just can’t decide!
my osa was 4.6, Gleason 3/4 ( 30% 4 ) , with suspected ECE and original t2 to be treated as early t3A to be safe.
option 1 - SBRT MRI linac plus Bicudamide 6 months - private - expensive as no insurance
option 2 - HD Brachy Boost plus Bicudamide 6 months - NHS
option 1 would potentially give less side effects and be kinder in toxicity, option 2 is a possible over treatment as they admit . But free!
im told both outcomes are similar. I’m 60 fit and healthy and just want a best chance of cure with best chance of no reoccurrence.
what would you do? I have the money in my pension and you can’t take it with you or NHS and hope I take to radiation ok?
possibly more options if reoccurrence with option 1 although I think also there are possibilities for salvage treatment with option 2?
thsnks so much.
Hi Angus
Well it's good that stats are low, Def helps.
SBRT , have read good things, just not sure about long term stats.
Brachy ok but have u considered Radiotherapy, I had it in 2017 and hasn't caused me any issues, a very simple treatment.
If me I would probably go for SBRT or Radiotherapy but possibly would consider NHS as they have so much experience, not that I'm saying private SBRT is an issue.
See what others say
Best wishes
Steve
Hi Angus JG - your option 2 is what I had. It’s known as brachytherapy boost. I’m busy in the Alps at the moment, but just got time to steer you to take a look at my bio. The bio gives a few extra references to more detail. AW
Thanks yes I have read your profile many times and it’s fantastic informative info.
Mine would be HD I think yours LD? I guess not much difference in terms of outcome.
what are the potential curative options should it come back say locally? I think salvage brachy can be done? Possibly salvage SBRT mri linac? I just want to ensure I don’t burn all my matches at one go as I’m 60 and don’t want to rely on ADT to keep me ticking .
Thanks Steve
For me it would be brachytherapy boost which gives 3 weeks radiotherapy after the internal blast of HD.
if I go nhs I can get a new car but will I burn my matches and go private I spend a dollop of pension which I can’t take with me and potentially cut down on having too much radiation too young ?
Hi Angus JG I don’t know enough about the success rates on both options but if they are similar then I would say RT isn’t as damaging as it used to be and SBRT/SABR is very targeted. I had 37 x 2Gy followed by 3 x 13Gy (SABR) 6 years later. My second point is about private vs NHS, I started my journey in private and it wasn’t straight forward to get back on the NHS path. My private consultant suggested going NHS with the comment ‘they have the best equipment’. I don’t know if that was just my area (Southampton) or across the country.
Best wishes, David
Please remember that I am not medically trained and the above are my personal views.
Hi David 2017,
I have to agree wholeheartedly with your private consultant.........
I had my RT at Southampton General last Oct/Nov - very impressed with the staff and the equipment. (No tattoos, no enemas) They have 6 Linacs, all with Surface Guided RT, which is much more accurate than conventional RT. I have been trying to find out how many treatment centres have this equipment, I have identified about 15 - out of 64 treatment centres. Not one person on this site has responded to me when I asked if anyone else had SGRT as their treatment. After my treatment I felt that I would have been hard pushed to find a better treatment centre than Southampton - and on the NHS !!
https://www.bbc.co.uk/news/uk-england-hampshire-68688198
(The article mentions 7 Linacs - there is one in Basingstoke too !)
Linac machines use IGRT and IMRT for more precise targeting and I think are now widely used although obviously not everywhere
Steve
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