Surgery or Radiation + Hormone Therapy

How did you decide on the 54 treatments versus shorter course? There is a lot of discussion in this forum about proton beam. Not available where I am. I am to talk to rad oncologist in 3 weeks for first time.

I remember half way thru my proton therapy I could barely walk. I probably spent hundreds of on line researching my condition. I found that 80% of the time what my doctor told me was wrong and twenty year old thinking. Her mind of thinking was that if your PSA is .01 that is great. Eighty percent of people aft Lupron therapy have the same issues. The doctor never even looked at my testosterone levels I went out and got my own test and it was 153. Right now my PSA is .1 it briefly went up to .2 when I started replacement therapy but returned to .1.
I take 1 mg IM every two weeks and feel fine.
I also recently went on the Carnivore Diet and feel better than I have in 20 years.
I fired my Urologist and fount a new one who is more familiar with current thinking.

Your situation may be may be much different than mine

I had the MRIdian Viewray radiation machine. I had looked at Proton therapy and other radiation machines. Many RO's say the outcomes are the same but I don't believe that for a nanosecond if you consider quality of life. Many make recommendations based on their experience with a specific machine or procedure because that is what they are used to. The side effects are certainly related to radiation so margins used by the radiation machine are important. Cornell Weill, in New York City is doing a 1 dose treatment as part of a trial study, on the MRIdian. Try and get backup opinions for everything. Second opinion from an RO outside the local system, Decipher test as a backup to the pathologist report, consider using Spaceoar.., keep coming back to this web site .all helped me feel better on an imperfect decision. I completed my 5 radiation treatments on Valentines day. Flomax preemptively prescribed and after 3 treatments, I took it and it helped restore flow quickly. Good luck.

I’m beginning to think half- half! of my treatments came from whatever pharmaceutical or radiation company paid my doctor. He definitely seems to be money focused. He is the highest rated in my area and I am still alive after 15 years. So that is good. And he follows what I read here and elsewhere, but never is there anything but more treatment… ughs.. I applaud you finding a better path for yourself.
I agree with your approach.

It is interesting that most doctors go by the conclusions of Huggins and Hodges that Testosterone is like pouring gas on prostate cancer. As it turns out they only gave Testosterone to 3 people and only one of them had there Cancer get worse. Yet doctors have been pushing this for 35 years.

Be careful I was diagnosed in 2018 they found two small spots on my prostate doctor told me I was good for 10 years before I have to worry about it three years later he left the prostate went to my bones it’s in my ribs my sternum my scapula now my back once it goes to your bones and metastasizes become stage four cancer if he would’ve told me that back in 2018 I would’ve told him to take it out and radiate it but they said they were into active surveillance that’s the tricky word in my opinion it’s like waiting for a bomb to go off and it went off he never gave me that option I talked to a friend of mine he found two spots on his two and they went in and radiated him and killed him and he’s fine right now which is what they should’ve done the mirror is give me that option I went from not worrying about it fighting for my life now so don’t be afraid to get second or third opinions make sure you trust the people that are telling you what to do good luck oh by the way I’ve had radiation treatments I’ve had chemo now I’m on a treatment called Xovigo

digger: I couldn't agree with you more. Many of us have an inherent trust for the professional that what they say must be ALL true. Too many shades of grey with Cancer and too much long term risk to put all your eggs in one basket.

I would love to hear your other story since I just turned 65 and have just been diagnosed with several 4+4’s. And am just starting the explorations of options

I was diagnosed with Stage 4 in early January. Prostate is a wreck and 3 spots just in my pelvic bones, confirmed with a PET Scan. Started Casodex, then Zytiga followed by Eligard. Radiation starts in April. Did a lot of reading about how terrible ADT is and how exercise can minimize the effects. I walk between 7 & 8 miles a day (having a 2yr old Labrador helps). I joined a gym and hired a personal trainer (who has also had prostate surgery). So far, almost 5 weeks in and the only problem I have had is the occasional hot flash. My PSA is down from 6 to .15 and I honestly don't feel that bad. Push yourself to exercise, your life may depend on it. Keep that in mind when you don't feel like it.

It appears that we all agree. This is a problem that should be aggressively addressed by very competent and experienced specialist that deal with prostate cancer all the time. Wait and monitor is only ok when your Gleason score is low and your in your mid 80s