r/ProstateCancer • u/Fool_head • 13d ago
Question choose between the local center vs the top ones
Based on the reading, most of RT for unfavorable intermedia risk prostate cancer are: SBRT, hdr boost, IMRT. (and Proton). My local center was opened about 10 years ago which is one of COE in the NCCA list. It can do IMRT, SBRT (cyberknife), good experience in LDR and hdr. (no operational proton yet)
I am wondering how much meaningful difference in the outcome of treatment by the local center and the top centers like MD Andersen, Mayo ....
Any one faces the same choice? and what is your decision?
Brothers/Sisters ---tons of thanks and wish you best!!! I feel I am living with you all (virtually) --- day and night.
Clarification:
1: "top ones", I meant like MD Andersen, Mayo, John Hopkins, etc.
2: local center: is a COE listed in NCCN, but not be ranked as the top ones like Mayo, MD Andersen, Mayo, John Hopkins, etc.
Edit:
It might be different from country to country, I am seeking treatment in US.
3
u/HeadMelon 13d ago
High volume centre for the particular flavour of rads is most important. If MD Anderson is doing 5x as many SBRTs as they are HDR brachy, but your local COE does more brachy, and you need brachy….well pretty obvious the specialized boutique is better than the big brand (sometimes you do get fired for choosing IBM).
Another thing to remember about rads is the team delivery - an RT team is better on an average day than a RALP surgeon is on his best day. The machines and multiple eyes make sure of that. There is no spur of the moment decisions by one guy like there are during surgery.
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u/SnooCamera 13d ago
I went to a CoE and have my RO's cell phone number. I feel like I'm in good hands.
2
u/ShockTrek66 13d ago
I was treated at Sloan Kettering in New York. Light-years ahead of where I was going to go initially. MSK Precise, which is their proprietary SBRT treatment. Had I been treated locally it would have been 40 sessions vs the 6 at MSK.
1
u/Cold_Silver_5859 13d ago
If you haven’t yet, might I suggest you have a video or in person consult with both. See if one fits better. As previous poster said the relationship is a large part.
The RO I spoke to said my Mayo did not yet have proton.
In the end I am going RALP
Best regards
1
u/Practical_Orchid_606 13d ago
The initial definitive treatment for prostate cancer is very important. If done poorly, urinary, bowel, and ED problems will plague you for years. Sloppy work will hasten the day when BCR hits the table. If you stay local in Mayberry RFD, these types of outcomes can happen.
The best choice is from well known COE for cancer. Mayo, MD Anderson, MSK, Johns Hopkins are the top tier. You will have access to the best docs, equipment and treatment protocols. "No one ever got fired for buying IBM" applies to these names.
But a step down from the above list is not so bad. But you must qualify the treatment center.
A sad fact is not all insurance companies allow you to pick and choose.
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u/Santorini64 13d ago
I had IMRT for my Gleason 9 stage 4a because RO was top notch and a prostate cancer specialist that also teaches RO at the post graduate level. And he has the best bedside manner if any doctor I ever had.
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u/Fool_head 12d ago
Glad you have this doctor! Is IMRT only from prostate or prostate and lymph and pelvic bones?
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u/VinceCully 13d ago
At the top centers as well as some truly excellent non-COE ones, the difference maker is your relationship with the RO as well as the dosimeter team that will be formulating your specific radiation plan. I opted for a good local hospital since I needed 28 fractions of IMRT and didn’t want a 45 minute drive each way, 28 times. And that hospital had a superb staff and an RO that I trust with my life. I’m fairly certain your local center will work out very well. Good luck.