Hi Ray,
A local hospital is likely to only suggest options they can provide and there have been cases where the local PCT's or CCG's have refused to fund a form of treatment outside their area, even if they cannot provide it themselves. I have always advocated men consider all their options, even if it means travelling, (which may or may not rule this out for some men). This is where research on what treatments there are, where they can be had and how suitable they are for you as an individual is worth considering. You did well to find and have a treatment that fitted your circumstances. Certainly, Brachytherapy is a good form of RT, particularly at an early stage, though not without risk of side effects 'if a man is suitable.' The Guildford center sets out suitability requirements in their web site and says some patients may be better suited having other forms of treatment. Your original post would have been best similarly qualified. Many experts consider surgery is the 'Gold Standard'. This was the opinion of my second opinion who was and maybe still is, an adviser to the Government on radiation treatments.
In the past we have had men tell us that they had Proton Beam which they considered the best treatment even though they had to go abroad and pay for it. It is enormously expensive in the USA where they have the most experience of this treatment. Incidentally, Brachytherapy is less expensive there than surgery and much less than External Beam.
Treatment refinement is an ongoing thing which makes relative comparisons difficult because it takes 10-15 years of follow up to assess how successful outcomes are and for longer term side effects to be evaluated. As regards RT, IMRT then IGRT, Rapid Arc, and Cyberknife among others are some of these. Though not RT, HIFU, Cryotherapy and Nanoknife are other possibilities that are being refined and will be contenders.
I started my research in 2007 and practicing my own philosophy, had my primary treatment, (IMRT with Carbon ion boost), in Germany within a study. in 2008. Diagnosis came too late for effective surgery or Brachytherapy and I knew with a T3A that it was a long shot that my treatment would provide a cure though I believed it gave the best chance. I have therefore tried to keep abreast of developments and what is available in the UK and abroad. I recently had HIFU as a salvage treatment and have had no side effects though still need to have some further treatment for cancer in an iliac lymph node.
Men arrive at different individual conclusions regarding what is best for them. Age, medical contraindications, willingness and suitability of having an operation or not, considering RT as back up to surgery being easier than the other way round, recovery time, convenience and treatment time, aversion to surgery or any form of RT and attitude towards likely side effects are some of the various factors that men have to weigh and often come to different conclusions. In short, it can be 'courses for horses' when it comes to treatment choice.
Edited by member 21 Jan 2016 at 01:30
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