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I would be interested in the details of your Prostate Cancer Journey and treatment decision-making process, IF you are of a mind to share. Thanks ahead of time!

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Kugrad1975: I am happy to share though I anpologize for the length but I summarized below the best I could so that you could understand my decision process.

After the mri and the biopsy, which they put me out for, I had the Decipher test done. My urologist had suggested either prostate removal or radiation knowing my cancer was contained within the prostate.

I decided the risks of side effects for me were too great with prostate removal. Besides my online research, including Mayo connect, I had a friend who had had one of the first robotic surgeries, and he ended up having a closed system pump inserted because he needed that to have sex. I know there are people that have had successful robotic surgeries and their prostate removed but I wasn’t willing to take that risk and I read that 20 to 30% have biological reoccurrence. It obviously has worked for others, but it just did not make sense for my risk level. I understood that if I had radiation and wanted my prostate removed later on, that I could run into difficulties in finding someone skilled enough to remove my prostate after I had had radiation.

I researched the different types of radiation machines that were available in the market. I narrowed it down to Proton Therapy and the MRIDian Viewray machine. My goal with radiation was to have the least amount of healthy tissue impacted. The proton beam seemed a little more accurate but the mapping process and other process items struck me as being like any other radiation machine. I decided on the Mridian because it was the only machine with 2 mm margins (vs 4-6mm), a built-in MRI, so one could see in real time what was happening, automated gating, so that the machine turned off if the body/organs moved and the radiation started to go outside the mapped area, 5 treatments and it also had dynamic mapping if it was needed. Additionally, the Proton Therapy machines required two people while the Mridian required three and I liked the idea of three people watching over me as they radiated me.

In addition to going on the Mayo web site, nccn.org, Dr Walsh’s book, pcri.org videos and listening to the comments made by patients on there, I spoke with five Radiation Oncologists who’s Cancer Center‘s had the Mridian machine. In the case of Cornell Weill and a radiologist there, I was able to speak to three patients as part of their patient volunteer group who had used the machine for their prostate cancer. That gave me additional insight into both the Mridian machine, the experience on the machine, and the support from the various team members that treated them.

I also spoke with spaceor and their technical department. Again, with protecting the healthy tissue in mind, it gave an extra half an inch protection between my prostate and rectum. I was lucky enough to have a spaceor technician from the company in the operating room as well.

I spoke with the makers of the Decipher test. I was told by a couple of Radiation Oncologists that because the sample size was larger for the Decipher test that it was better than the Prolaris Test, which, by the way, I actually took first. Both had similar results.

I also took a myrisk test to identify male or female genes that might affect my son or daughter, because the Braca gene could affect my daughter if I had it, but I was OK in that direction.

I discovered and read that many of these doctors, even though they have devoted themselves to helping people who are sick with cancer, provided solutions in some cases that were based on their success experience even though there might be better choices around them. That is why back up opinions and back up tests were important to me as part of the process.

It is certainly not a black-and-white decision, but obviously other than PSA, I will not know for a while what my results will be. If I can get four or five years without cancer coming back, maybe by that time, the imaging, the radiation and other choices will be even better.

Sorry about the length and that’s the summary version. Good luck with your decision.