I post this only if it might be of interest to others on a similar path. Unless there are questions, I expect this to be my final post here.
It’s been a long slog but I had my last radiation session this morning. I am glad I chose SBRT (5 sessions at about 4X the dosage/treatment) vs IMRT/IGRT (25-35 sessions at lower dosage. Much better logistics since we live 140 miles (280 RT) from the site. Turns out SBRT is about half the total accumulated dosage vs IMRT.
I chose the Duke (University) Cancer Institute because it appears to be the best in the state for prostate cancer and among the top 30 in the US. I believe I received world-class care which should lead to the best outcomes. I could not be more impressed with the quality of care I received from every single person I encountered - my brilliant Radiation Oncologist, my wonderful Radiation Therapists and the dozen or so others who completed my Simulation and other appointments.
So far the amount billed is nearly $83K, and I probably haven’t see them all yet. Surprisingly Medicare has approved almost the full amount (way more than most procedures IME), and paid most of it. My Supplemental has paid all the rest so far.
The short term side effects they told me to expect have been: Fatigue - none that I’ve noticed. Bowels - minimal. Urinary - most noticeable but manageable. They did put me on Flomax as a precaution, I have no way of knowing if it’s helped or not since I don’t know what it would have been like without.
They tell me to be prepared for these side effects to continue to worsen over the next two weeks due to inflammation, but then a slow steady improvement and I should be fully back to normal in May.
I am very glad they inserted the SpaceOAR. But it’s an odd feeling, you’re aware of it 24/7. Feels like you need to “go” BM 24/7, so it’s a little harder to tell when you actually need to go. They tell me it will disintegrate and be absorbed in 3-6 months. So a couple months of the odd sensation.
PSA and first follow up in May, 3 months post radiation.
I am VERY optimistic. Even if I’m not 100% cured, I expect the “setback” to the PCa I had will be enough to bridge until something else kills me in 10-20 years.
An aside: Before my PCa diagnosis my prostate was enlarged slightly, 45 ccs, and I was experiencing a weaker urine stream (temporarily more acute now after radiation). Thought it was just BPH, not PCa. I think I read somewhere that now after radiation when the dead PCa cells have been absorbed and eliminated some months from now, my prostate may be reduced in size, which may improve my urine stream - that would be a very nice side effect.
Thanks for your support.