I’m 49; diagnosed 4 months ago. PSA at diagnosis was 118 w/ Gleason 9 - 8/12 biopsy cores positive. PSMA PET showed regional spread to pelvic lymph nodes and seminal lining - no distant sites seen in scan. I’ve spent the past few months making the rounds at different Centers of Excellence to learn as much as I can to ID best path forward. Consulted with Mayo, Memorial Sloan Kettering, MD Anderson. Landed on Orgovyx+Abiraterone (taken with Prednisone). Two of the centers also recommended proton therapy over standard (photon) due to proximity of lymph nodes to bowel. I’m going through the insurance process now to get proton therapy approved. I have a good commercial plan, however, the first request was denied. Second request involved a peer-to-peer and was also denied. My care team is presently working with a third party (Apollo) who specializes in proton medical appeals. They submitted a comparison plan last week and I’m waiting on a decision. If it gets denied again, I have one more level of appeal, to an outside board. I’m hopeful the treatment will be covered, but concerned it will not. Any advice? Have those of you who have undergone proton therapy been satisfied with the results? Did anyone achieve “remission?”