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← Return to Prostatectomy or Radiation? Lot of stress over which to choose
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Prostatectomy or Radiation? Lot of stress over which to choose
Prostate Cancer | Last Active: Dec 25, 2025 | Replies (116)Comment receiving replies
@climateguy
It is hard when told you have PC to know what to do. You also can get overwhelmed with information from others and then like you posted conflicting information from medical professionals.
I don't think I saw you were given information on proton radiation. They have pencil beam and scatter beam treatments that have the same success rates of photon radiation. The difference is possible reduction of secondary damaged, and secondary cancers caused to surrounding organs and tissues that photon can have a higher chance than proton.
The biggest difference in the types of radiation is not success rates but photon radiation continues throughout body where proton stops at specific spot.
I still ponder if I made right decision on dosage. I had consultations with Mayo urologist, Mayo R/O, UFHTPI R/O, and my Mayo PCP. I went through the complete prostate cancer information package given to me by UFHPTI prior to considering coming to them for second opinion.
I sometimes ponder whether should have gotten the 5 days high dose versus the 30 low dose I got just to get it over quicker. Put then my Mayo PCP and UFHPTI told me after the 5 high dose treatments started they were seeing more side affects sooner.
I hated to be told I had PC and it did change my life. But I feel I did everything I could to find out all treatment plans and the pros and cons of each. I don't think I could have done more so I have accepted did the right for me personally.
I did not see from your post that you had a Decipher test. Did you have that test.
Replies to "@climateguy It is hard when told you have PC to know what to do. You also..."
@jc76 I was curious about proton therapy, so at my first appointment with an RO at an NCI designated facility that heavily advertises proton therapy, I asked about it. The RO explained that the facility should stop advertising protons for prostate cancer: he said the people in the prostate cancer department all favored photons.
I was astonished that an experienced RO at a facility that had protons available, would not recommend protons, but that's what he did. One thing he mentioned was that although protons theoretically appear to not damage normal tissue on the way to the target cancer, the proton has an effect on other particles to get them on the way to causing problems the therapy hasn't been studied deeply enough to figure out.
Protons are a form of external beam therapy, as are photons. I became more interested in internal beam therapy, i.e. brachytherapy. The radiation source is placed right inside the target, i.e. the prostate or semincal vesicles, etc., either temporarily or permanently. Brachytherapy can deliver a higher total dose to the target area than any other RT. There is a lot of data supporting the idea that the higher the total dose that is administered to the target, the higher the likelihood of a kill.
The TRIP study supports the idea that if the local cancer source, the prostate, is blasted with more than 200 gray, the treatment failure rate is lower over a longer period than any external beam therapy alone can achieve. (The higher than 200 gray is achieved by adding a brachytherapy boost in addition to an EBRT).
I concluded that what matters more than theoretical descriptions of relative advantage is the data on outlook. I was surprised that there are many different ways to figure out what the outlook is. A common way is long term survival. Two treatments are compared and pronounced roughly equal in terms of survival at 5 or 10 years. What is left out is that one treatment might require less salvage therapy afterwards than another, which could be crucial to a patient's analysis, i.e. what is my quality of life going to be?
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@jc76 They are going to do a decipher test. They are also having their own pathologist review the biopsy pathology. So the treatment plan may change somewhat, depending. Any plan would include some time on ADT.