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After months of study I have eliminated every other treatment option except IGRT+Brachytherapy and Proton Beam Therapy.
My PSA is currently 3.5 (no change), Gleason 6 and 8 positive biopsy cores from 5% to as much as 80% involvement. The left side of my prostate is full of disease with but only 1 core at 5% on the right.
My staging is intermediate risk (probably T2b) and PBT looks more appropriate for low risk, so I am leaning toward IGRT+Seeds.
Any feedabck and wisdom anyone can give me is very much appreciated.
Aloha Robert,
Any PCa treatment will cause side effects. Combining two treatments means more side effects. Some men breeze by with few problems, others get more than they can handle. For the two treatments you have chosen, read the stories of men who have had those treatments and evaluate them with respect to your starting point. I chose EBRT/IMRT because it was a pretty good chance that the PCa had escaped the prostate even though it was not detectable. As part of this treatment, 1/2 the dose was directed toward the pelvic cavity. Even though ultra-sound imaging was used prior to each dose, I still had life changing side effects which even now, 3.8 years after treatment, are very difficult to live with.
If at all possible just do one treatment. I suspect that your doc wants to obliterate the PCa with an iron fist. This may be over kill. These decisions are not easy and the future side effects are completely unknown for you. Reading what other men have experienced is your only hope of minimizing the possible side effects.
Hang in there, & good luck,
Joe
You have nothing to lose by checking with a proton center to determine if they think you might be a candidate. It may be a little tricky without submitting all the usual paperwork, but it may be worth a shot.Best wishes. Don O.
I had seeds/Imrt 2 years ago and have had zero side affects. Psa has been .1 down from 40. Just be sure you have a brachytherapist that has done at least 500 procedures and an RO that has at least 250 procedures for PC. The data on proton is just not sufficient at this point in time to have me choose this treatment for anything more than a very low volume low grade cancer.
Thank you for your comments. Sometimes to need someone that has been there to help you confirm your thinking.
I think I will end up choosing Dr. John Sylvester, who has done thousands of external and seed procedures. He is from the group of Blasko, Grimm and Sylvester who made their fame with brachytherapy from its early days practicing in Seattle.
