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Experience with SABR

User
Posted 09 Dec 2023 at 08:17

Hi everyone 

Im 65 have just been diagnosed with PCa Gleason 3+4 with PSA of 3 The 4 lesion is small and confined to the posterior part of prostate. I have had urinary problems all my life - mainly feeling of needing to go, rather than inability to go or weak stream or urgency.

My consultant is a surgeon in North East so seemed keen to operate but I have been offered SABR which seems less invasive and with only 5 fractions needed less inconvenience. I am told spacers to protect recital issues aren’t available and treatment with an empty bowel is just as good. 
Has anyone had SABR recently ? If so how are they finding it post treatment with regard to side effects etc ?

User
Posted 09 Dec 2023 at 09:23

I presume you are being offered this treatment

https://www.bbc.co.uk/news/health-66946336

It is a relatively recent treatment, it's been trialed for about ten years and the results are good enough to suggest it should become the new standard treatment (for those suitable). It takes ten years for any prostate trial as it is a very slow disease and it will take a decade before you can tell if more or less people are surviving.

SABR has been used as a salvage treatment for metastasis for quite a few years and nearly all posts on this site mentioning SABR will be talking about salvage treatment. Make sure that any research you do relates to SABR as a primary treatment as that is what is being offered in your case.

 

 

Dave

User
Posted 09 Dec 2023 at 09:36

Thanks Dave. I’m still trying to find my way round the site and haven’t found any experiences with SABR as first treatment for intermediate PCa. Any guidance would be greatly appreciated 

User
Posted 09 Dec 2023 at 10:07

The design of this website is questionable. I found the search function and typed in SABR, it isn't obvious how the results will be displayed. Hardly any are about primary treatment.

Here is an example of someone who posted twice, on the 18 Dec 2019.

https://community.prostatecanceruk.org/default.aspx?g=profile&u=47295

It was either successful and he never needed to post on here again, or he dropped down dead on the 19th Dec 2019.

Without reading all the posts you find in the search results it is difficult to know which are talking about primary and which are secondary SABR. Fortunately I know a post also mentioning chemo, lymph nodes, metastasis, bones is almost certainly a secondary treatment, and a post mentioning PIRADS, MRI, biopsy is almost certainly related to a primary treatment.

Dave

User
Posted 09 Dec 2023 at 10:19

Thanks Dave. I’m still mulling over my options. Consultant pushing surgery but he is a surgeon with a nice robot to play with. Having done the YouTube thing (Dr Scholz seems very good on this) I’m angling towards RT with SABR but I need to have a discussion with the oncologist about pros and cons. 
My lesion didn’t even show in mri so was hoping for AS but consultant advised against. 

User
Posted 09 Dec 2023 at 12:05

I'm not surprised the surgeon has got his knives out for you. It sounds like you have a very easy cancer to treat. You will be very good for his cure rate statistics. I don't know why we know surgeons by name but no one knows the name of a radiotherapists?

My opinion is go for the least treatment that will do the job, others say take a sledge hammer to crack a nut. Just because I have that opinion doesn't means it's right.

Dave

User
Posted 09 Dec 2023 at 14:39
Just one point, depending on what your urinary symptoms have been Surgery is a permanent fix that will not need revisiting. Unlike radiotherapy which leaves a mushed up prostate behind.
User
Posted 09 Dec 2023 at 14:42

The surgeon pointed that out. But my symptoms are manageable and I don’t fancy the risk of long term incontinence 

User
Posted 09 Dec 2023 at 17:42

I had the 5-shot TopGun course as a primary treatment last May, specifically to take advantage of the enhanced accuracy to avoid loops of bowel, which had made traditional RT too risky in terms of collateral damage. I didn't have any spacer gel. My local oncologist was of the view that 5-shot treatment would become the norm, as funding allowed.

The treatment was pretty much a breeze. I had maybe 2 days in the week after treatment finished of not venturing far from a loo, but that was it. 

Has it worked? Who knows. PSA is undetectable well after my HT has finished and washed through, so I guess it's 'so far, so good.' I'm happy with my decision, which is all you can hope for.

As you will see from numerous posts here, it's somewhat unusual for the RT itself to cause major problems but very common for the companion HT to produce inconvenient side effects.

Best of luck on whatever road you decide to travel.

User
Posted 09 Dec 2023 at 17:45

Thanks for this. I’m not expecting to have HT which seems a bonus. The 5 day treatment seems to good to be true but 🤞

 
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