This is excellent. I have been going round in circles about whether to do SBRT at a top hospital in Paris, giving real headaches to my radiologist by bringing up the possible of advantages of proton therapy back in the U.S instead. And he keeps telling me, look, the studies show no significant difference in the long term side effects, while acknowledging that the higher doses of radiation in SBRT can lead to moderate short term impact on urination and the rectum for up to a month or so. So, assuming this Dr. here knows what he is talking about, it is reassuring to me that he seems to be confirming what my doctor in Paris keeps telling me. I am scheduled to get this done over a two week period in late November. Here in Paris they do four sessions, two each week. And I am looking forward to getting this monkey off my back, praying that I will be one of the two out of three patients who do NOT suffer from ED afterwards.
This video series is pure gold. Most doctors I have seen have at most 15 minutes of time to explain things and I will always have after thought questions. This video series answers questions I haven't even thought of and helps me make the decision I feel is right for me, Thank you so much for spending the time and energy to create and circulate these videos.
@@whocares0316 I researched like a madman. Sloan Kettering just seemed far ahead of others in terms of technology( ie they were using MRIs for simulations where others were using Cat scans
51 years old at diagnosis GG2 intermediate risk 3+4, Decipher .37, Treated with HDR Brachytherapy in St. Louis at Sitemans Two treatments of 13.5 gy over two days PSA went from 3.8, 1.1, .6, .8. I have another PSA test coming up soon at the 16 month mark. Little side effects, urethra felt scratchy but went away after 6-8 months. Sexual function is normal however amount of discharge is diminished by about 85 percent. I gave a lot of thought into this and am glad I chose to go with HDR. God bless. Hope this helps. Please be sure to stay fit, cardio and weight train.
Glad you had a good result. Can you provide the name of the physician at Siteman that did your brachytherapy. I'm scheduled to see Dr. Michalski in May. I had surgery scheduled but changed my mind and want to get a consult on all other options before I make a decision. Thanks.
Doesn't use of MRI - Linac with beam adjustment 6 times per second offering the ability to compensate for movement of the prostate during treatment offer a potential advantage of CT guided approach that uses fiducials and a single determination of the treatment field?
Whoa! 1 in 3 patients will have untreatable ED?? That's way higher than what my radiologist seemed to imply, that most of his patients are on Ed meds which implies it's not the untreatable kind
Recently diagnosed with prostate cancer after a biopsy. Researching available treatments for Gleason 8. Pending bone scans and CT scans before making decision. Great informative videos help ease the anxiety I’m beginning to experience. Thank you👍🏽
How do i find a treatment facility which specializes in SBRT in my home area near Atlanta? Do i need to go to a Cancer Center of Excellence for that reason? Thank you
Min 5:30 to 6 did it for me. SBRT it is. Thank you so very much for these videos. My doctor means well but his time is limited and I only end up remembering half of what he says.
Well, this is a very timely video for me personally. Probably for a LOT of people. Thank you! Question: Does LOCATION of tumor within the prostate affect recommendation for treatment (radiation vs surgery), and potential side effects? I realize that either radiation or surgery would treat the ENTIRE prostate, but suppose for example the tumor is at the apex of the urethra --- could this not increase the likelihood of long term incontinence with either treatment? Would this alter the recommended treatment?
That is a very good question since the apex is a common site for PC. I would wildly guess radiation would have less of a negative impact in this regard.
Thank you so much for your videos. They have been so informative and have helped me prepare for my SBRT treatment I just had my last SBRT treatment performed at UCLA. The convenience of five treatments every other day is simply amazing. Very little side effects and I have experienced very little zero fatigue.
I interviewed with a doctor today (Fred Hutch) here in Seattle who has a good reputation (status etc. and good reviews overall) who essentially said that there are not enough studies that could conclusively show which external beam radiation was best, as in least side effects and longevity. He does both Proton and SBRT/IMRT. I have a Gleason 9 (4+5) with PSMA showing localized cancer. Half these doctors when interviewing have no clue with the Tri-modal approach. That is, ADT/ Brachytherapy/External BEAM. Yet, in their notes that is usually the recommendation. His suggestion was IMRT but left the decision to me as to which one (proton or) He states (please clarify) that Proton is possibly more precise and does NOT exit unlike SBRT etc, which does exit. (goes in and leaves on the other side). I'm not sure if this is a positive or negative or if it really matters. Unlike the first doctor there who felt that space oar wasn't necessary, I didn't inquire with this one. I did however find his suggestion for doing IMRT BEFORE Brachytherapy unsettling! Is this common? Can this be done, or should it be done beforehand? Mind you, I'm having Brachytherapy with the best down (I'm in Seattle) there in the Bay area and these guys don't( imo) compare to Dr. Kurtzman. His suggestion is ADT/Brachytherapy/EB. The proton issue needs precise pros/cons. It's been around for close to 20yrs? It sounds from one perspective to be a good choice. Why? Well, how about precision and no exit? Any which way you look at it - they all pass through other organs which could possibly have a long-term negative outcome. What would your suggestion be for my case? I'm somewhat confused as I had an ExoDX test which showed a borderline reading (urologist stated: threshold) and a genetic test which showed ZERO for cancer as well as a DRE which was states as benign. However, I did start out with a PSA of 13+. I really like your style with ties! I used to wear ties like that to the office as well. Your selection however tops my former attire. I'd like to thank you and Alex deeply for lessening the serious gravity of prostate cancer. I have followed your advice much to the chagrin of my wife who is rather limited in her thinking on these matters. Typical standard old school trust the doctor and follow directions and what not. Mind you, I had a difficult time locating a urologist who would do perineal vs rectal for the biopsy AND to do a true targeted biopsy. One well known doctor here advertises targeted biopsies. False. Just a play of words. When it came down to the interview and dealing with the gatekeeper (MA) it was pathetic. He would "target the two lesions of questions but do a random biopsy as standard procedure. It's always the same line "to locate any possibly rogue cancer". As I said, I've read your books and have communicated with one of your team as well as review all your videos and all I can say is I'm grateful for people like you and Alex. Even Dr. Kwon is hilarious! I do feel you might have done a flip-flop with your latest Brachytherapy video related to advanced cancer with either High or low intensity. I believe your initial stance was for permanent seeds and not the high dose. So now - we have PSMA. And you have my situation. What is your suggestion, if you don't mind stating?
Congratulations on finding Dr. Kurtzman. I was so thrilled to find the video that he and his partner did about six months ago. I'm fortunate to do active surveillance right now, but if I ever get a higher Gleason score, I'm definitely planning to work with him.
Why don’t they talk about HIFU? One treatment and done, i’m 6 years cancer free, and still have my prostate. Doctors sell what they do. Not necessarily what’s best for you.
We have a few videos on HI-FU as well as the image guided HI-FU procedure known as TULSA-PRO: "FREE WEBINAR | TULSA PRO and ACTIVE SURVEILLANCE | Laurence Klotz, MD & Mark Moyad, MD, MPH" ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-ViAJTw4J3z8.html "Tulsa Pro for Prostate Cancer | Laurence Klotz, MD, 2020 Prostate Cancer PCRI Conference" ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-8XovfqV2RRk.html "HIFU and Prostate Cancer: What You Need to Know" ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-w1CU4WdZOLA.html "HIFU is FDA Approved, but Should You Get It? We ask Prostate Expert, Mark Scholz, MD" ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-sIeU3z2gUBE.html "Focal Therapy for Prostate Cancer | Prostate Cancer Staging Guide" ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-Sd_AO_V4m9w.html
@@urzsulaz2604 HIFU High Intensity Focused Ultrasound, not radiation. No chance of it causing a secondary cancer. And it has gotten so much better they can treat just the cancer without causing all the usual side effects. Definitely investigate it, and remember doctors tend to steer people toward what they know, don’t be afraid to get multiple opinions. I hear the insurance companies like HIFU because it costs a fraction of the other treatments.
