Radiation vs proton therapy vs surgery?

You may need more information about proton therapy and radiation options. My understanding is that proton therapy is fewer treatments at higher and more targeted dosage (may 5 treatments over 2 weeks?). Others should chime in here if I’ve got it wrong. Proton therapy’s advantage is that the depth of the radiation beam can be controlled to prevent damage to the colon. Similarly a radiation therapy called SBRT with placement of a SpaceOAR works the same way. 5 treatments of high dose radiation over 2 weeks. The SpaceOAR is a gel product placed by injection under anesthesia behind the prostate and in front of the colon. It stops the beam from traveling beyond the barrier. The gel is absorbed into the body over about 6 months (you’ll likely not even feel that it is there). I had this procedure 20 months ago at age 68. I’ve experienced no side effects so far. My PSA dropped from 15.47 to .07. Hang in there. You’ve done hard things and will get to the other side of this too.

Hi . You have certainly been through a lot recently and your frustration and confusion with trying to understand the various prostate cancer treatments and side effects is certainly understandable. First, let me say that it is true that prostatectomy can result in a loss in penis length in some men. That said, it is not across the board and research has found that, on average, it is not significant and usually not permanent (see: https://pubmed.ncbi.nlm.nih.gov/23102441/ and https://www.statnews.com/2017/02/13/penis-shrinkage-prostate-cancer/). I don't share this to diminish the issue. There are men here who have had worse outcomes on this front. I just want to share the research on most common/average outcomes.

Concerning Proton therapy, on top of the excellent information from , I want to share with a three part article our contributor Bobby wrote on his experience. Here is part I (there is a link to the next part at the bottom): https://prostatecancer.net/living/starting-proton-therapy. I also want to note that hormone therapy is not a requirement with radiation. It really depends on the risk level and localization of the cancer. Hope this information is helpful and that others chime in with their thoughts and experiences. Best, Richard (Team Member)

Hey, I just want to say first — everything you’re feeling right now is completely valid. When my family went through cancer, I saw this same fear and confusion up close. My mother had to go through treatment, and honestly, the hardest part wasn’t just the diagnosis — it was choosing how to treat it. Every option felt scary in its own way. My wife, Christi, and I spent countless nights reading, talking, and second-guessing everything. So I really understand what you’re going through. One thing I learned during that time is that every treatment comes with trade-offs, but understanding them clearly makes a huge difference mentally. For example, when we were researching DIEP flap breast reconstruction, we found that knowing the long-term quality-of-life outcomes helped us feel a bit more in control, even though the decision was still tough. We also came across some helpful, patient-friendly information here: https://txdiepflap.com/ I know your situation is different, but the decision stress — surgery vs radiation vs other therapies — feels very similar. It can really feel like there’s no perfect option. And about feeling like a burden — I saw my mom feel the same way. But from the other side, as a son and as a husband, I can tell you honestly: you are not a burden. Your family is there because they love you, not because they have to be. That feeling of wanting to just walk away from everything can happen when it all becomes too much. It doesn’t mean you’ve given up — it just means you’re overwhelmed. Try not to make any big decisions from that place. If you can, consider taking a second opinion and asking doctors very directly about real-life outcomes and quality of life after each option. That helped us a lot. You’ve already faced cancer once — even if it doesn’t feel like it, that shows strength. And you don’t have to go through this alone. Humanize 326 words