@jaygk Part of my effort when choosing my treatments was in minimizing risk. (Quality of life was equal priority with successful treatment.). As far back as 2019 (when I was researching treatments), there was some evidence that higher radiation doses over a short time period (days rather than weeks), even though the outcome was similar, increased the risk of urinary and rectal issues. So, I chose not to go with the shorter rounds of treatment - either photons or protons. (In 2023, Dr. Rossi spoke about this at a PCRI conference: https://www.youtube.com/live/WTqPnSRYtW4
—> starting at about 4:30:45.)

Yes, I chose 28 fractions of proton beam radiotherapy (to make use of proton’s Bragg-Peak characteristics in order to reduce entry dose, scatter, and exit dose) @ 2.5 grays per fraction. I asked them to use SpaceOAR Vue (again, to lower the risk of rectal tissue damage, as well as for the reported improved GU, GI, and sexual outcomes.)

Also, a second opinion on my biopsy tissues came back a 4+3. Not knowing which one was correct, the 3+4 or the 4+3, I chose to be treated to the 4+3 and asked them to add 6 months (two 3-month injections) of Eligard.

This was my radiation oncologist at UC: https://www.uchealth.com/en/provider-profiles/wang-kyle-1326481425

I also had a medical oncologist from Kettering Health (here in the Dayton area) to manage my hormone therapy and (still manages my) bloodwork: https://ketteringhealth.org/doctors/roxana-aguirre-pedroza-1144537135/

I chose UC because of their expertise administering proton radiation. I figured if they could hit a pea-size tumor in a child’s brain with protons with no peripheral damage, they could certainly hit a walnut-size organ with protons and cause no peripheral damage.

I liked Dr. Wang because he would talk with me and work with me. I’m a true believer in self-advocacy and shared decision-making. I’m not one to simply do whatever the doctor says to do; I’m not built that way. I need to understand and know what’s going on (why/what/when/where/how) and buy into it, provide my inputs into the process, and be actively involved in the treatment decisions. Dr. Wang and I worked well together in that respect.

We worked to minimize/avoid all likely treatment side-effects (see the attached chart that I created during those discussions).

I only had 1 day of adverse side-effects during treatments. On the 3rd day of treatment, I had urinary issues. My RO told me that with some men there’s an inflammatory response to the radiation, and if that inflammation is near the urethra can cause the issues that I was experiencing. He recommended that I take 2 Tamsulosin/day for the remainder of the treatments. Everything cleared up by the next day; I haven’t had any issues since. My “recovery” from the radiation treatments was uneventful.

My PSA is where it’s expected to be, since I still have a functioning prostate; at my most recent test in December 2025, my PSA was 0.314 ng/mL. (See attached chart of my PSA history.)