Radiation @ 82 yrs old - 5 day or 5 week treatments?

I spent 2.5 months weekdays at Loma Linda for proton radiation therapy in 2010. Loma Linda Children's Hospital was a pioneer in proton radiation, focusing on brain cancer of children. Later, proton radiation came to be and thousands of men have passed through Loma Linda over the years who had prostate cancer and selected proton radiation over the other options. From the year of researching this disease, it appears that less radiation over a longer period of time minimizes radiation-related issues. I have read on this site men who spent only a few weeks, but underwent perhaps stronger proton radiation and suffered in some ways, including urinary issues.
So, now 16 years later, my PSA is rising..significantly. Yet with MRI and PET scan, nothing conclusive. My last PET scan was in February of 2025. I am scheduled for another on May 28th. Remember, you are only under the "machine" several minutes each day. Besides, it give one time to chat with the nurses...good luck/ Leesburg, Fl

I was diagnosed with prostate cancer at age 90 in October 2023 and placed on ADT with Eligard 6 month injections. I have continued on ADT since with changes to Zoladex and now Firmagon.
My cancer is a Gleason 8 with cribriform, no large cribriform glands were observed in the biopsy. At age 91 is sought curative treatment. The oncologist I used suggested the short course SBRT treatment of 5 to 6 sessions in two weeks. This was concurred in by the radiologist. However, after a review by the group’s tumor board it was decided that SBRT would be too harsh at my age and the recommended treatment was Image Modulated Radio Therapy for 28 sessions of 2.5 grey per session for a total of 70 grey. I accepted that and completed the 28 sessions in June 2025.
During the radiation I went to the gym for an hour of exercise after the radiation 3 days a week.
Side effects have been mild and in the case of rectum proctitis found only by a stool blood test.. About a month after the radiation I started to have mile incontinence problems. A small pad had to worn when I went out to prevent embarrassment from any wet spots on the pants. This resolved itself without any treatment but recurred at about the 5th month and again went away without treatment. In the sixth month I had a stool test for blood. It was positive and a sigmoidoscopy confirmed mild proctitis. No treatment was recommended since it was mild. Now at the tenth month another stool test came out negative for blood. At no time did I have any physical systems of the proctitis.
I experienced no fatigue as a result of the radiation either during or after the radiation.
The PSA at the 10th month is 0.024
This is my experience with radiation treatment at an advanced age. Remember every man is different and others may have different experiences.

@overage
I know people, your age who are not on ADT because of the side effects and are just on Nubeqa Since it has no side effects for most people And doesn’t pass the blood brain barrier and cause brain fog.

You might want to attend an ancan.org Weekly online advanced prostate cancer meeting. They can talk with you about the fact that Nubeqa Is a real good option to avoid many side effects. You might ask your doctors about this. There are a number of people That attend ancan.org Meetings that are just on Nubeqa. Many of them are in their 80s, Possibly even 90s.

I have been watching the recordings of the Advanced Ancan group and find them very interesting.- I intend to attend a Ancan session after I obtain more information on a recently diagnosed condition that I think is the result of the extended ADT. I have an appointment on Monday with a doctor in my oncological group on that subject and an another appointment with a specialist in the middle of June. Once I digest their findings I will prepare for attendance at an Ancan session. As to the use of Nubeqa, I am still castrate sensitive with no metastasis so I do not meet the FDA requirements for that medication.

@overage
If you attend a meeting, get there 10 minutes early. That will get it so that you can be the first person that they will talk to. They will discuss your case and all the options available, As I am sure you have heard. You do need to have GoTo meeting Installed on your device, It’s free on every device you can use. Answercancer is What you put in to join the meeting.

It is true you do not meet the FDA requirement. Some doctors will ignore that. Not sure all insurance companies as well. Enzalutamide has been approved for use without ADT. It has fewer side effects than ADT.

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Thank you so much for your input. God bless...