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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Profile picture for toolbelt @toolbelt

In general SBRT treatment is whole gland rather than localized, with the best treatment including a focal boost to the actual lesion(s).
Stay Strong Brother, We Got This.

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@toolbelt
Yes. Whole gland.

Last year I’d had 12/12 cores positive.

This year is was 9/12.

So I hit the jackpot!!!🤣

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Profile picture for jaygk @jaygk

@robertov
Thanks.

They offered the 5 photon SBRT treatments but since I am only 20 miles from the center I opted to make the drive.

My RO stated he won’t be doing the focal boost.

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@jaygk what was the reasoning in not doing the boost?

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Makes it even better. Sounds like a sound choice. I’ve been happy with Proton, although I know I will be testing for most of my life. Gest of luck to you!

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Profile picture for toolbelt @toolbelt

@jaygk what was the reasoning in not doing the boost?

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@toolbelt
He didn’t specify why. Perhaps I will ask.

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Profile picture for jaygk @jaygk

@toolbelt
He didn’t specify why. Perhaps I will ask.

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@jaygk I think it is worth asking. I am no RO, but studies have shown the effectiveness of a boost.
https://www.thegreenjournal.com/article/S0167-8140(24)03546-1/abstract

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