Hammer looking for a nail
 

Wouldn't consider protons. Conventional VMAT works perfectly well. When I retired, we were still doing mostly 44 factions, some with 28 fractions, and considering SBRT dropping it to 5 fractions, but the jury is still out on SBRT as far as our doctors were concerned. It boils down to how many fractions can you drop (less fractions = more dose per faction) and still have the same outcome without unacceptable complications. Protons are great for treating things that don't move inter- or intra-fraction, but the prostate does move some even during treatment.

A transperineal prostate biopsy is now the only way to go. I had this done in 2022. At the time Hackensack in NJ was the only hospital in the state using this procedure. Much safer, more accurate for sampling and zero pain. Transrectal is old technology at this point.

OMG. Idoubt it was “chunks”. Biopsies are small scrapings.

I did stay at a Holiday Inn Express...

Xrays vs Protons
 

There are several terms for radiation treatments. Dont be fooled by terns like Photon or Cyberknife. Those are X-RAYS. Protons are NOT x-rays. Xrays enter the body and go thru the body and exit the body. Any organ in the x-ray's path can be damaged. Protons release its energy on target. No damage to any organ outside the target.

Children with brain tumors are always referred for Proton therapy to minimize long term issues when using x-rays. If Proton therapy is good for a child...makes sense it would be good for me too.

Most urologist will recommend whatever treatment they make money with. ie surgery, xray or seeds. All the treatment methods will kill the tumor, but the patient deals with any side effect. Dont want the possibility of wearing diapers the rest of your life? I suggest Proton therapy. These books can help you understand Proton therapy....

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This website can help in many ways...

Protonbob Homepage | Proton BOB

Yes I am a member of BOB...Brotherhood of the Balloon.

I had a friend that had a radioactive seed put in his prostate & he also said there was no pain during the exam or nothing. The only thing they told him that he wasn’t allowed to do is sleep with his wife for 1 week. I’m thinking that was the only pain he had, he’s got serious Dementia now though!

Prostate Biopsy
 

In 2019, my husband had a psa of 11. They did 32 biopsies at Yale New Haven. No complaints. Stage 3 so he opted for a robotic prostatectomy. He has a major side affect that I can live with because he is alive.

Had 2 first one was 12 panel and was negative for cancer, not to bad overall. The 2nd one was a 18 panel and they knocked my ass out !! it was miserable for 72 hrs afterwards but they found cancer, within 3 months had my prostate removed, they found my cancer went from 10% to almost 25% in the 3 months, very rare usually very slow growing. Im so glad it's gone!! Been 2 years and I'm cancer free!! This was all done at Northwestern Hospital in Chicago

God Bless him!

Interesting studies about treatment vs non treatment.

What Happens if You Don't Treat Prostate Cancer? with Dr. Michael Ahdoot

https://www.youtube.com/watch?v=S4GISK88Erg

Very old data.

That’s a complete and total bunch of BS. I am a firm believer in the power of data analysis for certain things that don’t involve life and death situations. Data has outliers, and I wouldn’t bet my life on not being an outlier. If my prostate cancer wasn’t treated 7 1/2 years ago, I would either be dead or in a very horrible place right now. Instead, I’m living a very fun, active, and cancer free life.

I suppose just like most everything else, a lot depends on who does the procedure. I had a total knee replacement done which resulted in constant pain (worse during P.T.) for nearly a month after and taking nearly a year for the swelling to subside completely. Conversely I have a sister-in-law who had it done a couple of years earlier--same procedure--who had pain for about a week afterwards with things back to normal by the six-month point.

Apples vs oranges :duck: or should I say bananas vs oranges? Quit the quandary? :ohdear:

Had one done a few years ago in the office without being knocked out. The worst thing ever!!😩😩
My new urologist said he always knocks you out.
Never again unless I’m knocked out!!

PSA test
 

I just read a book by the Dr who developed the PSA test and became aware of some very interest points.
- the PSA test is not FDA approved to detect cancer.
- Proton therapy machine costs upward of $100M
- Da Vinci robotic machine costs upward of $2M
- both proton and Da Vinci machines would not be profitable without frequent billings for prostate treatments
- most males will have prostate cancer if they live long enough and not be aware of it or die from it. the odds of having low grade prostate cancer increase expotentially as a male ages ( I think an 80 year old has about an 80% chance of having prostate cancer)
- 1 in 500 will have aggressive prostate cancer and probably die from it
- there is no good test to tell the difference between aggressive and low grade prostate cancer

Well, that's all encouraging information. :not:

You may want to throw the book away, it's out dated.

The FDA has approved the PSA test.

There are GREAT tests to tell the difference between low grade & aggressive PC. Example: Decipher's Prostate RP Genomic Classifier.

Hang in there..................it's not accurate.

:beer3:

Agree, and don’t forget the Gleason score as well.

A PSA test is a great marker for people who have had a radical prostatectomy. Only two things make PSA, a prostate or mutated prostate cells (prostate cancer). If the prostate has been removed, PSA should be undetectable unless some cancerous cells escaped or were left behind and begin to grow. No one who has had cancer is lucky, but at least prostate cancer patients are lucky to have such a specific marker to track the success of a radical prostatectomy.