MRI-Guided SBRT vs Proton Therapy (5-fraction)

Thanks SeaSuite. I've learned that ROs don't delve into a lot without prompting. I've had a PSMA Pet Scan (because of three slight small bone lesions MSK says are probably benign and are treating them as such; getting a second opinion on all my imaging- CT, MRI, Bone Scan and PSMA Pet Scan- from John Hopkins) and am getting Decipher. Have reached out to my sister's MO (she died at age 57 from metastasized triple negative breast cancer) and the Urologist-in-Chief at a top COE (friend of a family member) who replied to this question: "My preference would be SBRT but it is a slight push in that direction. It is close to a 50:50 decision but I lean SBRT. More data regarding safety IMO. Hope this helps but reassuring that you really cant go wrong." It's a close call.
All my research is a way to control what I can. And it leads me to believe, as you do, that there are significant technological advances occurring in this field.

@chaimkugel, to help your research, you may also be interesed in these related discussions:

- How did you choose between proton or photon radiation?
https://connect.mayoclinic.org/discussion/going-into-my-3rd-week-for-proton-radiation/
- Question on 5 proton treatments with ADT
https://connect.mayoclinic.org/discussion/question-on-5-proton-treatments-with-adt/
- Which centers offer 5 fractionated Proton Therapy for Prostate cancer?
https://connect.mayoclinic.org/discussion/5-fractionated-proton-therapy-for-prostate-cancer/
- Anyone had the 5 treatment proton therapy for prostate cancer?
https://connect.mayoclinic.org/discussion/anyone-had-the-5-treatment-proton-therapy-for-prostate-cancer/
- Starting Proton Treatments for Prostate Cancer: Any experiences?
https://connect.mayoclinic.org/discussion/starting-proton-treatments/

There are many other related discussions. To find them, simply insert keywords into the group search field https://connect.mayoclinic.org/group/prostate-cancer/

Proton beam therapy is available at Mayo Clinic's Arizona and Minnesota facilities and will soon be available at the Florida campus. Should you wish to inquire: http://mayocl.in/1mtmR63

I look forward to learning about what treatment you choose, especially what criteria help finalize your decision. I know it's not a simply solution and everyone has their own personal calculus as well as medical criteria. 🙂

Since you are working on a decipher test I wanted to know besides the siblings that had cancer, how far should we look in the family members. My husband is getting the decipher test on 3-7-24. They sent him a note about checking with family members. Do you think that parents and grandparents as well as siblings would be the most important. Of course, children and possibly cousins! That was sad to hear about your sister. My mom and mother-in-law died of HRT related breast cancer but they were both 89 years old.

I would suggest asking your doctor(s). I would report about any relatives who have had cancer and let the doctor assess what is material and what isn't.
What I read about the connection between TNBC and prostate cancer is that it is first degree relatives that are significant there (parent, sibling, child).

chaimkugel @chaimkugel,
What I have found now with about a year on MCC is there is still a lot of confusion and different opinions not only from patients but medical professionals over the advantage of proton versus photon.

I think the best thing to do is make your own decsion after listening to others, doing research, and getting second opinions from medical professionals. I know there is presenlty a lot of research being done on this subject along with the benefits and/or justifications for the drinking of water to move bladder away and the Space/Oar type of treatments.

My PCP at Mayo Jacksonvilled does a lot of research on the subjects above as he makes recommendations to his patients on treatments. He is at Mayo Jacksonville but wanted me to do a consultation at UFPTI because they offered proton where Mayo Jacksonville does not have (but coming). He did a lot of research at UFPTI when he was a medical student.

The SBRT photon has advantages just like proton. The biggest difference that you will be told by those who are NOT bias to either treatments is that photon radiation will pass through the body where proton will not. Thus the bias of those favoring proton is less radiation going in, and virtually none past the prostrate (or where you oncologist/radiologist) has the proton releasing it's energy.

With Photon and SBRT the moving of the beam from many angles helps reduce radiation exposure to other tissues and organs but it will still go through and out the body. I had something called proton pencil beam versus the regular beam (scatter) proton treatments. Why? I have a ICD/Pacemaker and the physics department at UFPTI wanted to stay away from device and the pencil beam is more highly accurate and beam restrictive.

You will also get a lot of different opinions on high dose (5 treatments) and low dose (20-40 treatmetns) and which is better. Basically what my PCP says is the cure rate is basically the same but research is showing some additional side affects with the high dose which is to be expected as is high dose radiation. I think the biggest benefit of the 5 dose is the convience of only 5 treatmetns where patients having reservations on time factor of low dose would not hesitate and do the high dose to reduce the time of treatments if that is a significant issue with them.