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What is treatment for Gleason Score 8 at 80 years old in good health?
Prostate Cancer | Last Active: 17 hours ago | Replies (85)Comment receiving replies
The only radiation I would consider is Proton Beam therapy. We don't know what your urinary continence is like as an 80 year old, but my RO told me that if/when I need radiation therapy, it would be a nearly 100% probability of lifelong urinary incontinence after radiation. I am now 10.5 months post-RP, and STILL have little dribbles and accidents. I wear a thin "Shield", and while I am now 95% continent and in control, I just can't make it to 100% yet. There is no way that "I" would personally tolerate lifelong incontinence after traditional radiation therapy, as well the the (low 1-5%) chance of cancer to follow in the years after (bladder/urethral and rectal). That is what got me researching, and Proto Beam therapy was the clear winner. The problem with traditional radiation is that while it irradiates the prostate "bed", that radiation is uncontrollable...it passes through the prostate bed and radiates other healthy tissue causing problems. But...Proton Beam therapy focuses the beam to the prostate bed, but that form of radiation does not pass through to other health tissue. So, you have far fewer side effects, if any. I too would stay away from hormones. I already feel like a girl since I have no had one erection since my surgery, so why allow your hormonal balance to be played with, and see you take on the emotional feelings of a girl?
Good luck
Replies to "The only radiation I would consider is Proton Beam therapy. We don't know what your urinary..."
@rlpostrp I don’t know why your RO would make a statement like that, unless your PROSTOX test came back high risk. Then it ‘might’ have an advantage.
If it didn’t, he’s probably pushing Proton therapy for the hospital system he works for. Those machines are very, very expensive and after they are advocated and lobbied for by either the head of radiology, a board trustee or some other muckety-muck, you had better use it a lot!
Not saying there’s anything wrong with it, but its vast superiority to photon radiation seems a bit overblown.
Did you ever read anything positive about photonic radiation in an article advocating/describing proton beam?
They make photonic radiation seem medieval compared to space age photons; meanwhile photonic radiation has evolved tremendously and it is a far cry from the treatments of yesteryear. If you do a search for side effects of proton beam radiation, you will find the same SE’s listed as for photonic. Best,
Phil
Phil
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@rlpostrp I think your RO was not giving an accurate picture. My personal experience (I'm 80) which included SBRT with SpaceOAR in Nov 2025 to treat two Gleason 9 lesions in the prostate and small lesions in two adjacent lymph nodes with 5 months of ADT (relugolix) hasn't caused any incontinence. The nocturia and bowel issues that lasted a few days after the SBRT have cleared. Certainly, we are all different and there are a range of radiation treatments and machines that are available. But it's an overstatement to say that incontinence is always a result of radiation treatment. Many who post on this forum have had experiences similar to mine.