Advanced Prostate Cancer
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Should I consider Proton Therapy

I am 75 and otherwise in good shape, I had Radical Prostatectomy in 2015 now 2 years and 3 months later my PSA has been rising, presently on Hormone meds (Casodex) to reduce PSA then should I go with Radiation or the much greater expense (for lodging etc) and have Proton-therapy 350 miles away? Comments /Suggestions would be very appreciated!

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Actually at Prostatectomy my Gleason was 8 & 9 and my PSA is now .26

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Looking for another 15 I take it. Good for you! It's six and one half dozen to the other. Believe me I looked high and low, was going to spend 60k of my own money and came across a reliable study that showed proton coming in a very close second for prostate. Brain, eye, etc.- proton. My two cents!

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You got it, all my relatives died around 90 :-)

Apparently my insurance would cover everything?

Thanks for the input!

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Hello,

Funny that you should ask about proton beam therapy. It happens that I just got back from participating in the Prostate Cancer Research Program run by the Department of the Army's medical branch. I met about 15 scientists there, two of whom were professors of radiation oncology. I asked each of them what they thought of proton beam vs. therapy with x-rays.

I think the short answer to your question is, there is no reason to choose proton beam over x-ray therapy. However, instead of explaining the reasons here I'm going to start a new topic because I think a lot of people might be interested in it.

Alan

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Thank you Alan that is interesting, I will watch for it!

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Hi Alan, where do I find the new topic? Thanks. Ed

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click on his name, and you can see his posts.

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For quick access, here's a link:

healthunlocked.com/advanced...

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Is the addition of Lupron or Zolodex in consideration as an alternative?

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Hi Yost, that is totally new to me, I'll check it out!

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Whether you may someday choose to have Radiation or Protons, you might ask your doctors exactly where they intend to direct the target beam, per their radiation treatment plans. Across the entire prostate bed? At some specific location? You may have time to learn/consult with doctors and facilities that can use advanced PET Scans (Axumin, PSMA, C-11, etc.) at appropriate PSA levels or other timing, and then use the results of those scans to guide treatment decisions.

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The question of where the beams would be directed is an excellent one. I would think that salvage radiation, i.e. radiation used after surgery failed to kill all the cancer, would be directed at both the prostate bed and the area immediately around the prostate, possibly including lymph nodes.

If that is the case, proton beam radiation is probably not a live option. It is my understanding that proton beam is never used for the area around the prostate. If you go to a proton center and the radiation oncologist orders radiation both inside and outside the prostate, then in the past at least, the radiation to the area outside the prostate would always be done with x-rays, not protons.

Alan

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Oh wow, thanks for the insights!

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Thank you, there is a lot to learn and consider!

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Thank you, there is a lot to learn and consider!

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Thank you all for your input,

I have Dr's visits this next week also axpect to get a reply from SCCA Proton Therapy Seattle. Will keep you posted as best I can.

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My husband is in a similar situation except that he had Cryo first. He just started Casodex yesterday & plans to go on Proton therapy too, with all that it entails. Please follow up with updates on your situation. Keep the faith!

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