Prostate Cancer
I am a 67 yr old, and I have been (within last week) diagnosed with Prostate Cancer. According to all my tests and scans, it is localized to the prostate. I have been being tested reqularly for 18 years had three prior biopsies, multiple MRI's and other tests, all negative. Had laser enumeration last year and they removed 67% of my prostate, it is still 50 plus cc's. Recent PSA was 24 so we did an MRI, PI-Rads of 5 in certain areas. Biopsy of 17 samples, 9 came back with cancer with Gleason scores of 7-9....more 9s than 7s. Urologist has referred my to an onocologist and my appt is next Tues, 28 Feb. They told me my options are surgery or radiation with hormone treatment for two years. Research photon vs proton radiation vs surgery and information is hard to come by in comparing all of them. I live in an area that gives me options. Any input?
Be sure to get second opinions.
So far there has been no proven benefit of proton over photon per Dr. Mark Scholz at the Prostate Cancer Research Institute which deal with the major cancer treatment centers.
If the cancer is outside the prostate I would expect that the choice would be based on whether surgery or radiation can better access the location, but that again is a question for second and third opinions.
Guy B. Meredith, moderator.
https://www.youtube.com/watch?v=_Z1SbFNSlTs
By the way, hormone treatment is chemical castration and leads to menopause with all the symptoms of menopause.
I chose to remain sexually active during hormone treatment despite lack of libido to help avoid penile atrophy.
Guy B. Meredith, moderator.
Hi
. It is good that you are doing research and seeking out information. Yes, you will rarely find the type of three pronged analysis you mentioned. There are mostly analyses and descriptions of differences between surgery and radiation and between types of radiation.
The issue is really about the nuances. Each cases is different. Asmentioned, there are circumstances that can make either surgery or radiation more favorable or preclude surgery or certain types of radiation therapy. Age often is consideration when both surgery and radiation are options. If the cancer has escaped the prostate surgery may not be helpful. The aggressiveness of the cancer can dictate radiation recommendations. For example my father-in-law had a combination of Cyberknife and traditional radiation because of some spread and higher risk the doctor thought Cyberknife alone was actually too precise and wanted the wider scope of some traditional radiation to control for any unseen spread.
I say all of this not to confuse the issue, but to point out that the specifics of your case will determine what options are viable and then you can narrow your choices based on your needs/goals for treatment and post-treatment (such as the fact that some side effects occur right away after surgery and then fade/recover, while they don't immediately occur with radiation, but can rise up years later).
Hope this information proves helpful with ongoing discussions with your doctors and with any second opinions. Please don't hesitate to keep us posted and ask additional questions as you learn more. Wishing you the best. Richard (ProstateCancer.net Team)
