Proton therapy with short term hormone therapy

I was gleason 3+3. No cancer in the margins. I elected for LARP nerve sparring. I am partially incontinent and partial erection. Over 4 yrs ago. Pet scan was clean and PSA < .1. No other treatments. So maybe I got it. But it came at a cost. I would probably do it the same way again. Probably a little more research on my surgeon.

Thank you for your response. Did you have your procedure at Mayo Rochester? If so, may I ask who your doctor was? Thank you again and good luck on your journey.

No. At the time Mayo Phoenix was not taking Medicare. They now take Medicare but not Medicare Advantage. I switched to Mayo after my surgery. I see a Dr Wolter for my after surgery issues. I used a Urologist out of Mesa Az that is part of the Banner Health. I am not the best of patients. Dr insisted I monitor a 3+3 with a 1.2 PSA. I refused and requested he remove it. Like you my father had it at an early age and died from it years later. But he was 87. I figured at 68 and healthy I might as well get it out. I could always treat it later with other procedures. But its usually not possible to use nerve sparring to remove it after other treatments.

Thank you again for your response. All the best!

With my localized 7(4+3) w/PSA of 7.976, I chose 28 sessions of proton radiation + 6 months of Eligard + SpaceOAR Vue. I had treatments during April-May 2021. Treatments were relatively uneventful, and I’ve had no lingering adverse after-effects. PSA now varies between 0.35-0.55; most recent PSA test in May was 0.47. (Not bad for still having a prostate.)

Curious about your choice between proton and prostatectomy. Those are about as far apart as far apart can get. How did you decide down to those two? (You say that “you’ve been offered.” What do you want? It’s your call.)

I wanted to balance quality of life with survival (of course!) along with the possibility of treatment in the future if needed (as medical treatments progress). This was about utilizing the best treatment techniques to get the best outcome while still surviving and maintaining my quality of life. (Every medical-related decision I ever made I made the same way; why not this?)

With proton’s Bragg-Peak characteristic, proton was the right choice for me.

I am a 4+3 also. 3 of 12 cores were +. 1 was 4+3 and two were 3+4.
My choice was brachytherapy - however they discovered a stricture and pulled Brachy as an option. I tried to avoid ADT , but after an extra Dr opinion I chose to go with the recommendation of Proton and ADT (due to the 4+3) instead of possible metastasis.
For me - surgery was too much of a risk of incontinence and sexual dysfunction. Plus I had disease in the left side nerve bundles.
I am only a short way into my treatment. 11 of 44 radiation treatments and almost 5 weeks of ADT.
I hope you can research enough to have confidence in your choices.
I used videos of Prostate Cancer Research Institute to help make my decisions. Dr Mark Scholz - Along with other testimonies.
Best wishes

I elected surgery at age 72 for my G 9 disease. Still required Salvage Radiation treatment w/ short term ADT, very shortly after surgery (pathology postop confirmedG 9 w/ EPE).

Now 74 w/ undetectable PSA 1 year post salvage treatment.

I would elect surgery again.

However Radiation (whether photon IMRT or Proton) have statistically similar outcomes.

Surgery first gave me the backup treatment of radiation. Surgery not as available with Radiation as initial treatment.

Challenging treatment decisions.

Best wishes.

I was 4+3 in 3 cores and 3+3 in 3 with Gleason 8.7. Cancer was encapsulated and I chose 28 proton treatments and NO hormone therapy treatment which was recommended by oncologist and radiologist. Decision to forgo hormone therapy was based on age (74) and quality of life considerations. PSA now .78 two years later. Fingers crossed!