u/Practical_Orchid_606

I had a long talk with my HDR nurse at MSK concerning the prep leading up to my procedure next week.

A question concerning ADT as an adjuvant to radiation has been raised on this subreddit.

Some men start ADT concurrent or after definitive radiation treatment. MSK's treatment is radically different. They start ADT months before radiation. For me, it will be 2 months at time of HDR. Why? They believe low testosterone shrinks the prostate for better targeting. It stops the progression of the tumor. But the biggest factor is low testosterone makes the cancerous lesions more sensitive to the radiation.

The nurse said the relationship between PCa, low T, and radiosensitivity is well known.

I visited MSK in Westchester today to be screened for anaesthesia use during HDR. They go through great lengths to ensure no issues during the surgical procedure. Blood draws, EKG, and detailed examination of my meds. My procedure is considered low risk. But RALP is considered high risk. I can only imagine its screening procedure. Compare and contrast: Just a few months ago, I was under general anaesthesia for my perineal biopsy. Then, there was no elaborate screening for anaesthesia. What I saw today was the high attention to detail which sets a Center of Excellence apart from others.

The Westchester facility is large and modern. The waiting room was full of patients that I knew some were PCa patients. All of them knew the issues before them through the power of MyChart. The concerned look on their faces foretold the questions they had for their doc. "Can you spare the nerves?" "How many months of ADT?" "It's been 1 year why have my erections not come back?" So on and so forth.