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Treatment Considerations

User
Posted 22 Jun 2021 at 00:39

Thanks Dave,

That's a great perspective, you've given me much food for thought and I am spurred on to research a little deeper into the PACE trials.

I see my Oncologist again next week and will have the chance to question him further.

One question that has come up listening to the PCRI is whether the higher dose of SBRT together with a larger than average prostate gland would lead to a significant increase in the risk of damage to other healthy tissues.

I would welcome other's views that have considered or taken part in SBRT treatment.

Thanks for any help, Don

User
Posted 22 Jun 2021 at 00:53
The data suggests that a higher dose over a small number of fractions leads to fewer side effects.

In your case, I can't see any great benefit in knowing your starting testosterone level as you will only be on HT for a very short time but for men on long-term HT for advanced PCa, measuring their testosterone at every PSA test is a useful evidence that the hormones are working.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 22 Jun 2021 at 02:10

Hi Lyn,

Yes, I noted that. I think the PCRI guy was trying to say that where the prostate has a larger volume, the beam would need to cast a wider net and thus irradiate more tissue. I certainly doubt that PACE B would have stratified their results on this variable by now or even ever. Seems a mute point, but I'll raise it with the Onco anyway.

Yep, seems like I'm barking up the wrong tree on the testosterone test thing.

Thanks a lot for your advice.

Don

User
Posted 22 Jun 2021 at 02:23
It may be of interest to note that the Chief Investigator for the CHHiP trial was at The Royal Marsden which was one of the participating hospitals. This compared men having the standard 37 fractions each of 2gy compared with 19 or 20 fractions at around 3 gy. This showed the fewer number of fractions at higher dose compared well with the standard way of administering. This hypo fractionated dose with advantages for the radiation unit and the patient has been increasingly adopted in hospitals so you could say the Royal Marsden have form for this. This principle now seems to be applying to SRT. Unfortunately, with RT, only time will show whether giving higher doses less often will be more or less successful than current way of administering SRT.
Barry
User
Posted 22 Jun 2021 at 03:17

Hi Barry,

Thanks for drawing my attention to that trial...I wasn't aware of it. Bedtime now, but I will read around that a bit tomorrow.

Cheers, Don

 
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