Prostate Cancer Outcomes - Report Card

Radiotherapy is lately a broad category, and I did not see it broken down. Photon vs Proton. 30,28, or 5 treatment protocols, View Ray vs ERBT, margins. So many variables. Then add in weather the patient had ADT or not along with the radiation. All have different results. Then throw in age. Studies show that ADT makes little difference if you are over 70 versus younger. Choosing which treatment is a such crap shoot. Glad I was 73 and if I get 15 years it makes me 88 and I sure don't want to be in a nursing home.

Well, this February 2023 report is of >8500 men between 2008 to 2018.

It will (likely) take time to assess and report on the 10+ year mortality and negative side effects of all the new radiation variants currently available.

It’s assumed all the latest radiation variants will demonstrate 97-99% 10+ year survival rates, or they shouldn’t even be considered. Of course, even this must be tested and proven (maybe they already have demonstrated that level of survivability).

IMHO the key takeaway from this report is that the mortality question is really no longer the relevant question…it’s hard to beat a 97-99% survival rate.

IMHO the only reason to consider a new treatment is that it can be shown to significantly reduce negative side effects.

If a new treatment doesn’t provide clear and indisputable evidence that the negative sides effects are significantly REDUCED, as compared to all the ones presented in this report card, then IMHO the jury is still out as to its value in replacing a known treatment.

I should make clear that I am only discussing new treatments that are recommended for those with Low and/or Intermediate Risk PCa. High risk and metastasized PCa is a different story.

Hopefully, there is (or soon will be) clear evidence that these newer treatments are statistically PROVEN to reduce treatment negative side effects.

I would be interested in seeing and evaluating such data, if anyone can provide source information.

God I do wish you luck. I am sitting my recliner writing this now.
Before this happed I was working on my “bucket list”. Already had a black belt in Go-Ju karate. Decided to get an advanced under water scuba certification. Got a certificate to captain and sail sailboats up to 51 feet. I could and did about anything. But one error in judgment that led me to falling for a doctors sales pitch on robotic Prostate surgery led to my current condition.
I am not saying this may not be a good choice for many. But be sure the person doing the surgery is a real surgeon and not a eurologist that got some training how to operate thaw robotic machine.
Good luck and God Bless

The report discusses EBRT using x-rays, so that would be photon and not proton.

oops

Yes. My guess is that there were just too few proton therapy folks in this group, between 2008 - 2018, to break them out separately.

It would be interesting to see a control study regarding negative side effects data of photon versus proton therapy.

Of course, both of these types of radiation treatments are now “fractionating” into quite a few variations.

Stan so sorry to hear about your problem. So strange that you can't walk now but before you could do 10 miles a day.
I would hope that you keep trying to hang in there and do not think your life is over, there just might be a new answer to your problem just around the corner.
jack

I can relate completely; however, my surgeon was a renowned urologist/surgeon who actually taught and co-invented the procedure. He appeared on TV, etc. He treated the rich and famous - of which I am neither - and told me that many urologists were ‘schleppers’ who took a few courses and called themselves surgeons.
Five years later I am totally impotent - even with meds- sometimes dribble or more and now face a recurrence with a rising PSA. I try really hard every single day to tell myself that nothing’s guaranteed, people do the best they can, sometimes shit happens and as the old joke goes “ Senor, sometimes dee bull Wins!!”
I think all the talk about outcomes is useful, but there is a LOT of the unknown in everything you do.

Stange is the least of it. I have worked out my entire life. Black belt in karate.
Have been a weight lifter since all I had was a “Bedford stone” I used to do bench presses. Been retired for about 20 years.
Lifting weights and walking (knees too bad for running). I have a weight machine now that I used every day. Until I had this operation.

Like me, it seems that your core was destroyed. 5 swords piercing your muscles and belly will do that. I still can’t lift what I once could and have one or more incisional hernias. The procedure sucks no matter how they spin it as ‘less invasive’, more precise, etc. I consider myself officially ruined in so many ways - but I am alive and live to fight another day. And what Nietzche said about being stronger if something doesn’t kill you? Hasn’t really panned out for me….best of luck!