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Ronoir (@ronoir)

prostate cancer treatment choices

Prostate Cancer | Last Active: Jul 21, 2019 | Replies (54)

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Hi @fairway5, welcome to Connect. You're so right that choosing between robotic surgery and proton beam isn't easy. There are so many factors to consider such as short-term and long-term potential side effects and quality of life, which are different each person.

I'm tagging a few other members, like @kujhawk1978 @cupman @norske46 @403211th @waynen @hodagwi @donnelson, who can share factors that helped influence their treatment decisions.

You may also be interested in this Video Q&A about Prostate Cancer, where Dr Castle talks about cutting edge advances using robots and proton beam

Fairway, what did you learn during your consult about proton beam therapy?

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Replies to "Hi @fairway5, welcome to Connect. You're so right that choosing between robotic surgery and proton beam..."

I chose robotic surgery in Jan 14 when I was diagnosed. At the time, it was that or radiation.

I felt surgery gave me the best chance of the gold ring, the cure. I also felt comfortable in the hands of a very skilled surgeon.

It was a very successful surgery, T2CNoMx, GS8, margins, ECE and seminal vesicles negative.

I was up and walking the afternoon after my surgery and discharged the next day. At home I started with short walks and gradually increased them. The catheter was not an issue, didn’t need any pain medications.

A week after surgery I was playing basketball, the catheter came out and I was dry, the surgery was nerve sparing so recovered function in 12-18 months with the help of Cialis.

I felt that if surgery failed, radiation would be an option to treat recurrence, the opposite was not necessarily true. So, having an option in case of failure, BCR, was important to me.

You can research pre-operative advice, if you go the surgery route your medical team should give you pre and post operative instructions, heck, there are videos you can watch of the surgery if you want, I did.

My surgery was successful in the hands of a very skilled surgeon and his supporting team.

Unfortunately I had BCR after only 18 months, SRT failed but after doing 18 months of ADT, six cycles of taxotere and 25 more radiation treatments my PSA remains undetectable a year after completing that regimen.

If you decide on surgery the choice of your surgeon is important. It helps if you are in good physical shape and your health is good, weight, BP, cardio…I was 57, weight under control, I was physically active, played basketball, lifted weights, ride my bike, swam, hiked in the mountains, went skiing…

Times have changed since my surgery and there are many more treatment choices, better imaging than the CT and MRI, combination therapy, just depends on how aggressive you and your medical team want to be but the tenets remain the same, do your homework, know your options, make your decision based on quality of life, side affects, possibility of a cure or length of remission. Be at peace with that decision and enjoy your time after in remission.

I hope whatever your decision it brings you long term remission or that “cure!”

After reviewing the nature of my prostate cancer, with a short physical and DRE, I was confirmed a candidate for surgery or external beam radiation therapy. We covered the benefits and side effects of radiation and advantages of the proton beam approach. All the details of how radiation therapy is planned and delivered were discussed. Next, the different fractionated schemes were discussed. The choices were 8 weeks (standard), 5.5 weeks (hypofractionated), and 5 days (ultrashort fractionated). If I selected surgery the possibility of additional radiation treatment, if adverse pathology was found, was also discussed. A clinical trial was also available for image guided radiation therapy with of w/out androgen suppression but I won't consider this because of rules about randomly being assigned to a group that didn't include proton beam.

I'm hoping someone who has been through 5.5 week proton beam therapy can share their experiences on Connect.

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