Patient Forum

The CyberKnife Patient Forum is designed to provide a place for people who have been diagnosed with cancer, their family and friends, to exchange useful information and provide support to one another. The Forum may also help people find answers to questions they have about the CyberKnife treatment experience. Accuray strives to facilitate these exchanges and encourage discussions. Recently we have experienced some aggressive or inappropriate spam postings. We are diligently working to resolve this issue and thank you in advance for your patience.

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Gleason 3+4: HRT brachy + SBRT??- Opinions please
Emily J
Posted: Thursday, May 03, 2018 9:11 PM
Joined: 5/3/2018
Posts: 2

Hello, My father was recently diagnosed with prostate cancer Gleason 3+4 on both a 2.5cm anterior lesion (very close to bladder neck) and additional 0.5cm posterolateral lesion. We received second opinions on the biopsy path and also performed a second targeted biopsy of the 2.5cm lesion (total of 8 cores) which all came back as Gleason 3+4. His PSA has been ranging from 12 to 17 for the past 4 years (had multiple negative blind biopsies in the past, until 6 months ago when the prostate MRI showed anterior lesion, which was missed on prior blind biopsies). He is opting for radiation, however we are completely lost on what's the best course of action for someone with intermediate risk like himself. He has seen a doctor at MSK in NY who recommends SBRT with ADT, Dr. Stock at Sinai recommends EBRT + seeds brachytherapy and Dr. Zelefsky recommends combo SBRT +HRT with or without ADT. Based on the MRI, the capsule is bulging and it is very close to the bladder neck which means the bladder is at high risk of radiation. It looks like a not very aggressive cancer, given the fact that his PSA has been elevated for so long, and we want to obviously proceed with the best treatment however want to limit the side effects. He is 60 years old and very healthy. Is the combination therapy overkill? He is having a hard time deciding what to do- prostate cancer treatment is such as grey area and can be so frustrating at times. Thank you so much for the great forum. So much valuable information here!!
Gleason 3+4 (2.5 cm anterior lesion and additional 0.5cm posterolateral lesion) PSA 12- 17 (for past 4 years)
Posted: Friday, June 22, 2018 11:06 PM
Joined: 10/10/2008
Posts: 852

Suggest contacting Alan Katz MD Radiation oncologist in NY NY. As a prostate cancer treated with the CyberKnife 20 years ago, I am biased for treatment with the CyberKnife. No lasting toxicity and biological control after ten years! My PSA is 0.2 ng/dL.

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