Considering Tulsa Pro or Proton radiation (full gland)

Posted by jaygk @jaygk, Apr 23 8:04am

I was diagnosed with stage two prostate cancer a year ago. Biopsy showed 11 cores of 3+3 and one core of 3+4 )less than 5% of 4). Bilateral No perineural invasion . That biopsy was an ultrasound. Decipher of 0.32. So I went on Active surveillance.

I had a repeat biopsy This year.
It was an MRI guided biopsy (not sure why I didn’t get an MRI guided biopsy last year ??) and I had an additional core of 3+4 (35% of 4) and the urologist re-sampled one of the tumors and it came back 3+5 (but less than 5% of the 5). On this biopsy I also had perineural invasion. No cribaform. I am sending the 3+5=8 for another decipher test

I’m afraid that my cancer didn’t grow in that year, but it was due to the better sampling of the MRI guided biopsy.

PET scan showed no escape

ED an incontinence is very important to me.

I had a consult at a newer Tulsa pro site and they stated that since I needed a whole gland ablation that I was not an ideal candidate due to the possibility of recurrence in 2 to 3 years. I like the advantage of Tulsa pro gives with reduced side effects and the availability of further treatment, including another Tulsa Pro procedure or radiation.

I am considering getting a second opinion from the Texas Prostate Institute, which is a higher volume Tulsa Pro site

I am also considering proton radiation consults at the university of Cincinnati . (I think they use a Varian machine with gantry) at the University of Cincinnati. I am leaning towards the proton radiation and the 28 sessions to reduce effect on the rectum and bladder and other organs . I have severe diverticulosis and generate many polyps during each colonoscopy. The downside of radiation seems to be in 2 to 3 years some of the same side effects start to appear as surgery.

I just read about getting the Prostox test for sensitivity of radiation

My questions
1) is it worth it to get a second opinion from the Texas prostate Institute on full gland ablation by Tulsa pro or is it too risky?
2) I’m considering 28 sessions of proton therapy. What is your opinion of that for my cancer
3) and is it worthwhile for me to get the Prostox test for radiation sensitivity?
4) any other advice?

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stldadof4 | @stldadof4 | 15 hours ago

In reply to @jaygk "@stldadof4 that sounds very similar to my experiences at Kettering for Tulsa. I wasn’t sure if..." + (show)

@jaygk We do have a lot in common on this journey. I had a low ArteraAI score (similar to decipher) just sent off my prostox too. I had not heard that about SBRT. Like you, I’m pretty close to the treatment center so I don’t feel like I need to conserve trips. I totally agree with you that there seem to be so many options all with their own life-altering pros and cons. It is very overwhelming. The cynic in me wonders if it’s just a big money grab. I’m sure there is an element of that since there is such a large industry built around any type of cancer, and PC is the only one I have firsthand experience with. I also hope that you and I (and all of us who are on this road) can pick the option that seems right and then move forward with confidence. From reading about others, it seems like that is typically the case and guys are happy with the path that they chose. Just takes a lot to get there. All the best to you on this journey