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To follow up on my prior post, my dad has biopsy confirmed prostate cancer at age 71 (PSA 6.78, DRE - T2a or T2b, Gleason Score of 6 and a brother who died from prostate cancer about 12 years ago at the age of 68).
His Biopsy showed, 40% cancer cells in the Left Apex, 15% in the left midline AND right apex, 5% in the right midline, ??? in the left base and NO cancer cells in the right base... he had 12 samples taken but, combined in 6 tubes for insurance.
We consulted over the past 3 weeks with his urologist and radiation onocologist (who has had patients do proton beam for lung cancer and is familiar with Univ. of Jacksonville and proton beam) and we've researched, and dad has narrowed it down to 2 options...
IMRT/External Beam radiation OR Proton Beam Radiation. He thinks the long term results may be the same, but I'm not for sure about this??? Any thoughts?
As he sees it assuming the outcome is the same in long term results -
Pros for External Beam/IMRT - it can be done locally, while he is retired and can afford to be away from home, being local would be an advantage because there would be less disruption in his life.
Pros for Proton Bean - it will have less short and long term side effects, it can deliver a larger dose of radiation to a specific site.
Can anyone help us decide some of the things to consider (beside the disruption in life being away from home for 2 months and 2 prior trips down to get it set up...)
Are there any NEGATIVES we aren't considering with proton beam or NEGATIVES we aren't considering with external beam?
We've read stories, but I think everything about proton beam is coming up "too good to be true so there must be a negative we aren't seeing and it can't be as good as we've seen"... I think that might worry him a little.
Also after proton can he be followed up by his regular Urologist and if he has latent side effects can they be treated locally or will he have to go back to FL for treatment?
Thanks in advance if you take the time to answer these questions!!!
You ask: “IMRT/External Beam radiation OR Proton Beam Radiation. He thinks the long term results may be the same, but I'm not for sure about this??? Any thoughts?”
Both of these treatments are radiation: both have the same potential risks and potential long term results.
The essential difference is the phenomenon referred to as the ‘Bragg Peak’ which enables the proton beam to be focussed very accurately and because of this, if the procedure is done by an expert, the chances of damage to other cells is reduced significantly.
Men who have had proton beam treatment are by and large very enthusiastic about the treatment and as such there is some concern that this may mask some of the side effects which may not be reported. There are very few independent reports about proton beam – the main studies coming from Loma Linda which has been doing this procedure for many years as you know. Their studies show very low levels of morbidity or side effects, but then as cynics would say, you’d expect that wouldn’t you.
You also ask: “Are there any NEGATIVES we aren't considering with proton beam or NEGATIVES we aren't considering with external beam?”
It is not too clear what negatives you are considering, but as I say above there’s not a lot to choose between the two in potential outcome.
You then ask: “Also after proton can he be followed up by his regular Urologist and if he has latent side effects can they be treated locally or will he have to go back to FL for treatment?” As far as I am aware any treatment for morbidity associated with either treatment would be dealt with by the same specialist – probably not his urologist. There would certainly seem to be no reason to return to Florida, since it would not be possible to have nay further radiation.
I hope you have read the material on the Yana site, including Sonny Jones book.
For what it is worth – not too much I’d say – if I were choosing a conventional treatment I’d probably opt for Proton Beam by an experienced team.