As a 71 yo recently retired Family Medicine physician, I was diagnosed in February with Gleason 7-3+4, prostate cancer with 1 core positive of 12 and was only seen on one side of the prostate on MRI, even though it can be microscopically multifocal. After evaluating all of my options, I chose Proton Therapy and received 30 treatments equaling 72Gy of radiation. My radiation oncologist was extremely knowledgeable since he was the first at using PT at M D Anderson in 2006. They were fifth in the US in its use. He asked if I wanted hormone therapy and I replied only if absolutely indicated so we delayed until my tissue was sent for genomic evaluation. I was discovered to have high risk cells. The results were available after about 2/3 of my PT, so I began Leuprolide (22.5mg x2) and bicalutamide (50mg orally daily for 60 days). I have completed the oral treatment and now anticipating a second Leuprolide in about 2 weeks. My first post treatment labs show the testosterone diving from 711 (upper limits of normal) to 8 (way below lower limits of normal on a different scale), and PSA from peak of 4.9 to < .o6. I have been an active runner since 1987. I recently experienced an overwhelming fatigue, weakness, muscle aches, and of course, poor sleep. I chose PT in order to maintain a good quality of life with as successful a cure rate at radical prostatectomy and external beam photon radiation therapy with dramatically less side effects. The ADT has complicated that and I am in a dilemma regarding taking the second Leuprolide. I think the studies are still in progress and not to be reported for another 2-3 years about the conclusive value of the adjuvant ADT for someone in my intermediate risk category.
Everyone is different and I am Blessed to have discovered my cancer early. The science is not absolute. My life has been Blessed beyond measure. I want to be active until I cannot and I am not certain about the return of my strength and endurance at 72, soon. I post this mainly to show that we are all a bit different and must make our own decisions. God Bless all of you! I pray that your suffering is as minimal as possible. Thanks for the time. rog

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