Patrick C. Walsh

“The clearest short-term yardstick may be the PSA nadir (discussed above). One study of 743 patients at Memorial Sloan-Kettering Cancer Center in New York confirmed that higher-intensity radiation does a better job of achieving a rock-bottom PSA level. Of the men who received higher doses—76 to 81 Gy—90 percent achieved a PSA nadir of 1.0 ng/ml or less; 76 percent of men who received 70 Gy and 56 percent of men who received 64.8 Gy achieved those low PSA levels. But there was a trade-off—the men who received higher doses of radiation also had a significantly higher rate of gastrointestinal side effects, urinary tract complications, and impotence. To overcome these side effects at high doses, intensity-modulated radiation therapy”
― Patrick C. Walsh, Dr. Patrick Walsh's Guide to Surviving Prostate Cancer

“(IMRT) has an advantage. The newer, high-dose, conformally directed, external-beam techniques for radiation therapy such as IMRT have been in widespread use for less than ten years; IGRT has been around for an even shorter time. However, some reports of long-term success are now emerging. New studies suggest that at ten years, high radiation doses alone can produce PSA control or cure rates in 93 percent of men with low-risk prostate cancer. What about more aggressive prostate cancer? As we discussed in chapter 9, the best treatment regimen for men with intermediate- and high-risk prostate cancer is still a moving target, but it will likely turn out to be a combination of high-dose radiation and short- or long-term hormonal therapy.”
― Patrick C. Walsh, Dr. Patrick Walsh's Guide to Surviving Prostate Cancer