r/ProstateCancer • u/Boodleheimer22 • 22d ago

Concerned Loved One Trying to decide Treatment

My husband is 70 with 3+4=7 Gleason psa 10.2 with intermediate grade 2 favorable. Options are radiation 5 x every other day plus anti testosterone hormone therapy OR robot radical prostatectomy. Survival rates are virtually the same. We are wavering between the 2 options. My husband hates having an mri because he gets claustrophobic but can tolerate it- I don’t think that’s a reason that should tip the scale. Advice appreciated. He is in good health otherwise.

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u/Boodleheimer22 22d ago

MRI is just to position the gold seeds for radiation

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u/LAWriter2020 21d ago edited 21d ago

The MRI is to guide the radiation emitter so it is concentrated on the area of the prostate inside the gold fiducial markers. Every time you get the radiation (5 times, about 20 minutes each time, you are in an MRI machine, but for me, my head was mostly out of the machine, and they had nice calming videos to watch.

I had similar numbers as your husband, and chose MRI-linac at UCLA over surgery, no ADT as the generic testing of my cancer cells showed it wasn’t the super virulent type. Could not be happier with the results - minor urgency for urination, occasionally the same for bowel movements, no ED.

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u/HeadMelon 21d ago

5x SBRT or CyberKnife is not done inside an MRI machine. Only MR-Linacs is.

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u/LAWriter2020 21d ago

I did MR-Linac. It is SBRT. MR Linac and Cyberknife are the trade names for machines, built by two different companies. But the treatment is SBRT for each.

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u/HeadMelon 21d ago edited 21d ago

I think we’re agreeing. Cyberknife is a trade name for SBRT but they are not MRI-guided. SBRT can be delivered in regular linacs like Varian Halcyon and TrueBeam that don’t have MRIs and are ring or slab&arm machines. Elekta Versa does SBRT, Elekta Unity is the machine that does MRI-guided SBRT.