Ultra Hypofractionated Radiotherapy

I had this as a 5 fraction back in May. It was a very straightforward process: lie back, breathe slowly and listen to Pink Floyd. I had just a couple of days, in the week after treatment, of not venturing too far from a loo, but otherwise experienced no problems. 

In my case the rationale for this treatment was not so much the shorter period of hospital visits, but the better targeting offered by the MRI-Linac machine. My internal plumbing meant that the local radio team could not get a sufficiently clear shot with their equipment. And my T2C generated differing prognostic views on how likely it was that an op would succeed in removing all the cancer.  So it was an op, or the Top Gun machine. I went for the machine.

I had to go privately, but am now back under the monitoring care of my local oncologist. His view was that my treatment was the way to go.

As with all RT, it takes a while to know if it has been successful, but I have no regrets and would make the same choice again

Hi Tony,

 I am the same age as you, and my diagnosis was similar to yours- Gleason 3+4, T2 (although mine was a T2C, which influenced my choices a bit). Starting PSA was just under 18

My pathway was not particularly straightforward. I had opted for RT after diagnosis for a mix of reasons- some purely subjective ( I didn't fancy the op and its attendant risks) and some a bit more objective ( I felt RT might cast its net a bit wider to deal with the measurable possibility that my cancer had begun to edge outwards). 

 I was started on Prostap, with a brief  blast of Bicalutamide to overcome PSA flare, but this failed after a few months, so I was switched to Zoladex. It took a few months, and another blast of Bical, to get my PSA down below 4, but when they began to measure me up for the RT it became obvious that there were too many loops of bowel too close to the action. So a rethink was needed. To cut a long story short , a second and third opinion led me to the MR Linac option.  

All in all, I was on HT for 2 years before treatment was finally started, but that was largely unplanned. Other than this lengthy period on HT no additional procedures were involved- no extra medication and no gold seeds. The point about the MR Linac is that the machine is recalibrated to you at every session ( so no need for tattoos and the like) and is monitored in real time during the treatment sessions. In fact one session was paused mid-flight while a bubble of gas worked its way round.....    I experienced no discomfort.

You'll need to work out what works best for you, but I'd say there's no reason to be worried about the higher dose treatment. Although I chose it for the enhanced accuracy, the research I did suggested that there was no downside risk to the higher dose rate, and if anything a slight upside.

Best of luck

There's no doubt that RT is advancing in both its accuracy and the quantitative way it's delivered. I had both gold seeds and tatts with the MR Linac being re-calibrated before and during treatment. In the background there's a massive computer that takes up a large room. There's also radiographers monitoring screens showing what's going on inside you. I was lucky enough to get a guided tour [well worth it if they'll let you have a look].

RT is being delivered in different ways, in different parts of the world, so if you go that way it would be useful to know how up to date your oncology department is. The advances in RT shouldl lead to less HT after the RT treatment.

Jules