Decided on brachyboost plus 6 months ADT

[EvFC]

My husband made his treatment decision today. After a lot of research, questions and consults, he has decided on brachyboost (EBRT plus brachytherapy) plus 6 months of ADT. It was a tough decision and we both know way more about prostate cancer now that we ever wanted to, but I am glad we did our due diligence. Thank you to everyone who encouraged us to take the time to look at options and thank you for all the support getting through the last two months.

Now we move forward and hope for the best outcome, and try not to look back. It’s hard because you want guarantees, but there are none. We’re both on the same page with this and I hope he gets through it without any long lasting side effects. Thanks again 🙏🏻

[OldVTGuy]

I think you made the right choice. I was similar and now 4 months off ADT and everything looks good.

[EvFC in reply to OldVTGuy]

Thank you! All the best to you.

[timotur]

Brachytherapy is a good choice and you’ve caught it early in the game. With GL-9 you may want to consider longer term ADT, and follow-up with pelvic radiation (IMRT), just in case. Your PSA a few months after Brachy may be the determining factor. I had HDR-BT/IMRT 5 years ago with little SE’s (see profile).

[EvFC in reply to timotur]

Thanks for the feedback. Brachyboost is a combination of EBRT and brachytherapy, so he will be having both. Hope my husband will have few side effects too. All the best!

[SongofFred in reply to EvFC]

I think what timotur was getting at is that Brachyboost doesn’t necessarily mean the EBRT aspect is radiating beyond the prostate itself. For higher risk cases there is the option for the EBRT to include the whole lymph/pelvic area to quell any undetectable cancer cells that may have spread to lymph nodes- the first place PCa usually goes. If you google “MSK nomogram prostate cancer”, you’ll find a personalizable calculator that will give you the approximate risk for recurrence for your husband. Generally, if the risk is above 15%, pelvic radiation should be considered. And I imagine 4+5 is going to be much higher than that. I was right around 15% at 4+3 and my very high decipher score tipped me toward full pelvic radiation. You have one chance to hit it strong from the start and hopefully avoid life-long ADT. I’ve seen a few studies over the last year or so showing 12 months ADT seeming to be the sweet spot if you’re having Brachyboost for contained high-risk (as opposed to 26 months for standard EBRT). I chose one year Orgovyx and Nubeqa myself (28 days left!) It’s definitely manageable. Best of luck to you.

[EvFC in reply to SongofFred]

Thank you for clarifying. Our radiation oncologist had explained to us that the benefit of brachyboost was that the EBRT would target a wider area beyond the prostate and the brachytherapy targets the prostate itself, which is advantageous with high risk prostate cancer. I thought that approach was standard for brachyboost, but from what you’re saying I guess it’s not in all cases.