Finished 28 Proton Therapies

Thanks for all the comments. My husband found out yesterday that the trial that he volunteered to do was set for him. 50% would have no water administered during radiation and 50% would have water administered. He is in the water category. I'm actually relieved because they don't know yet how patients will do without water which is the normal procedure. He also has an appointment for the Decipher test on 3-7-24. His paceror surgery was moved up to 2-29-24 and CT and MRI scans on 3-1-24. I hope that he gets relief from the shingles that he has had for 3 weeks. The bumps are drying up but he is still in a lot of pain.

There’s a saying - “If you’ve seen one prostate cancer, you’ve only seen one prostate cancer.”

No two prostate cancers are exactly alike; and the differences determine the treatment regimen that’s performed.

What might seem like random numbers - 5, 10, 20, 30, 40….. of radiotherapy sessions (I had 28 of proton) - actually involve a very detailed calculation for each type of radiation that considers the cancer severity, different biodosimetric parameters, dose rates, treatment times, energies and fractionations.

For your specific case, you’ll have to ask your RO which option provides the best outcome with the least side-effects —> higher doses with fewer fractions, or lower doses with more fractions? (I asked my RO that question….and more.)

With each of them, the dosimetrist calculates a biologic effective dose for optimum treatment and successful outcome.

Hope that helps answer your question.

The RT at CA Protons said that you can do proton therapy again. RT at City of Hope said you can do photon therapy again.

Data from Dr. Kwon (of Mayo Clinic) indicate that if there is recurrence following initial radiation, 45% of the time the recurrence is not in the prostate - it’s elsewhere in the body, so surgery to remove the prostate isn’t even a consideration.

If recurrence following radiation is in the prostate, there are many other options, other than a salvage prostatectomy — all depending on the nature of the recurrence. I personally know 2 guys who have had repeat SBRT because recurrence in the prostate was just a single spot.

Surgery following radiation is a last and final option only if there are no other options available.

Depending on where you go the radiologist/oncologist will decide and possible offer you different options. There are some oncologist/radiologist that prefer the longer doses over shorter ones based on their experience with side affects.

Some will prefer shorter citing both have equal cure rates. So it can be your choice if you are given options to do them. What I have seen is major providers will give options for treatments. I know UFPTI (My particular oncologist/radiologist) does not like to do the shorter treatments. He cited some increase in side affects which I would expect due to high dose. This opinion and comment is not just from him but my PCP at Mayo said his research showed the same thing.

I thing the biggest benefit of the 5 dose versus longer treatments is that it far easier to manage and deal with (over quick). That might encourage those hesitant to do it versus not wanting to have to deal with 6 weeks of treatments or longer. It comes down though if you have options make them in what is best for you not what is best for others. Do research, get second opinions and then pick what is best for you.

you're oncologist makes that decision-, do not compare your projected treatments to other patients - you medical status is solely yours and supposedly he knows what's best so you do not have to repeat the proton beam therapy a second time if you have a reoccurrence.

jc76

Thanks for the reply. I see some people underwent 30, 40 rounds of Proton treatment. Some only went with 5 rounds of treatment. Is this by choice or decided by their Radiation Oncologist in Cancer center according to their level of PCa?

@frank1956
I had 30 rounds of proton radiation at UFPTI. I was told by May Clinic Jacksonville at a Prostrate Seminar that most urologists do not want to do surgeries after radiation treatments. If makes doing the surgery very difficult.

The commentator did say it can be done but only a few will do it.

Hope this helps and this came from Mayo Jacksonville Prostrate Seminar and not my personal
opinion. When and if you have recurrence your urologist, radiologist/oncologist would be best to asked about what treatments for you. I believe it would be based again of degree of cancer (risk levels) and where and how much it has spread outside of prostrate or still in the prostrate only.

Just know that there are still many treatments that can be done outside of sugery.

If you have Proton therapy first, and later in life you experience recurrence, what kind of treatments will be still available to you? Can you still do surgery, or go back to do Proton therapy again?

everybody has to find their sweet spot when it comes to drinking.