Proton Therapy

[greed]

For 65yr old man with two tumors in the prostate (3.5cm x 1cm and 1.5cm x 0.6cm), surgery has been recommended. GLEASON 7 4+3 in most biopsy samples.

Could proton radiation be used to treat tumors of that size?

[Tall_Allen]

There was a recent randomized trial that proved the protons were no better and no worse than photons:

prostatecancer.news/2024/09...

[Don_1213 in reply to Tall_Allen]

But they are much more costly..

[JohnInTheMiddle]

Also Mr. Greed, this forum is for people who are not as fortunate as you, but who have metastasized cancer beyond the prostate! It's a very different set of concerns, in many respects. May I suggest you visit the Prostate Cancer Network community, also by MaleCare, here on HealthUnlocked? A big success on your journey!

[greed in reply to JohnInTheMiddle]

It has metastasized to lymph node and iliac bone.

[JohnInTheMiddle in reply to greed]

In that case, welcome. Also when you get a chance if you would be so kind as to share some helpful information in your profile.

[dhccpa in reply to JohnInTheMiddle]

In profile?

[JohnInTheMiddle in reply to dhccpa]

LOL - nice catch. Maybe it was the Zeigarnik effect at work! 😃

[dhccpa in reply to JohnInTheMiddle]

Dang Zeigarnik! What's he doing hanging on our forum?

[WisdomSeeking in reply to greed]

In that case surgery is not an option and I don't know why it was recommended to you.

[WisdomSeeking in reply to greed]

Because lymph-node is positive, RT should be whole-pelvis, not prostate-only.

[WisdomSeeking]

I think it should cure it. First apply ADT (hormone therapy) to shrink the tumors, then RT (either photons or protons).

[hfl20]

In short - yes. My prostate is large and had a large amount of cancer. One tumor size is almost identical to yours. All biopsies were G7 or G8. At MDACC I was offered surgery, IMRT, or IMPT plus a suggested 2 years of ADT. I started ADT (Orgovyx and Erleada) in July '22, had IMPT in Dec '22 and Jan '23. 22 fractions to prostate, seminal vesicles, and lymph nodes, the last 16 skipped the lymph nodes. I stopped ADT about 6 months ago - PSA remains undetectable and testosterone has slowly risen back to a bit over 100. I personally chose proton over photon. Due to the Braggs peak effect of proton radiation less healthy tissue will be irradiated. As Tall_Allen says, the results and side effects are similar. SBRT is the current choice of many since it often (or perhaps always now) is done in 5 fractions. In my case it was not a good option due to the size of my prostate, the high risk of my cancer, and my existing urinary issues. The larger number of fractions in theory allow healthy tissue (like your urethra) to be less damaged with each treatment and somewhat heal throughout the course of the treatment. Regardless of which treatment you select, the skill and experience of those treating you can in large part determine the outcome, so if possible select a Center of Excellence facility and doctors with lots of experience treating prostate cancer.

[AlmostnoHope]

Proton is no different than Non Proton like tall Allen said. It will result in Cystitis like I have 12 years later. A lot of fun.

[wilcoxsaw in reply to AlmostnoHope]

Were you treated with protons 12 years ago?

[wilcoxsaw]

I have had 80 proton treatments to date. I have no side effects. To answer your question, yes it can be used for your treatment likely, consult with a proton specialist to find out specifics in your case.

[Garfield-_1234]

My Gleason score was 8/9. My wife & I did an extensive amount of research before settling on Proton Therapy. Surgery has a long recovery time & there was very little pain with Proton Therapy (almost none). My Therapy ended on Jan 3, and my first PSA test isn't until 3 months after (end of March), so at this point I really don't have any results. Proton Therapy was able to reach my lymph nodes (the cancer had metastasized to two of them), other forms of radiation therapy cannot pinpoint those nodes or reach that "depth" (to my understanding).

Good luck on whatever you choose.

[FlowerPowerBB]

I was treated with ProtonBeam radiation after six month of total testosterone blocked ADT for a recurrence of prostate cancer in May 2022. Small tumors were identified in the lower left lumbar region near kidney just outside the pelvic bed region. - 25 fractions, Proton Beam Radiation, for prostate cancer metastases (less than 2 cm) in lymph nodes, left lumbar posterior region below kidney – (3/16/22 – 4/19/22)

This was a second recurrence following the first recurrence in 2013 that was treated with photon radiation. Original diagnosis in 2008 that was treated with prostatectomy and photon radiation. PSA monitoring detected both recurrences.

Photon radiation was not recommended for this recurrence because of previous tissue damage to colon and other tissue in the 2013 radiation. Because of the more precise focus of the ProtonBeam the previously damaged tissue could be avoided.

At this time, 3 years after ProtonBeam treatment, my PSA is still undetectable. I have no other treatment for prostate cancer as of 3/6/25. PSA checks at 3 month intervals.

[glenf]

Back in 2010 my Gleason was a 'hard 7' and I had proton therapy at Loma Linda. I'm here today to tell you that my PSA is now 0.2

[RoseDoc]

If you have metastatic disease, most would recommend radiation treatment rather than surgery. "The horse has left the barn" is the expression.

As for photon/proton, the literature shows no appreciable difference between the two. It might be best to discuss those options with a radiation oncologist.

I wish you the best!

[j-o-h-n]

Greedings Mr. Greed,

Would you please share some of your greed by updating your Pca data into your bio. All of your info is voluntary but sharing it will help you and help us too. Thank you and keep posting.

Good Luck, Good Health and Good Humor.

j-o-h-n

[T911]

In answer to your question I had similar size tumors, Gleason 8 and was treated with Proton along with ADT and HDR Brachy. Everything going well so far.

[Calipro1961]

Tall Allen is 100% correct. I did make the choice of Proton and was satisfied. I do agree with the comments of Seeking Wisdom.

Getting a 2nd opinion and creating a team you can consult with throughout your journey is invaluable.