Prostate cancer - Proton Therapy
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Has anyone recent experience with proton therapy for high grade PCa? I am interested in the cost and the side effects experienced eg impotence and incontinence. Also how long does the benefit last before further treatment is required?
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ES28567 barney34567
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barney34567 ES28567
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As an aside, as I see it, both radiation of any type and surgery leade to ED and impotence but radiation delays their onset.
ES28567 barney34567
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barney34567 ES28567
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barney34567 ES28567
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ES28567 barney34567
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There is also research going on to use HIFU for other treatments such as brain cancer.
If you look these doctors up, they both have good websites with video of how the procedure works and testimonials from men who have had the treatment and what the procedure was like.
So, the downside is...it's still relatively new (no long-term,15yr. Results yet). It is focal so there is a chance some cancer could be missed and a repeat procedure needed. It is not available on large prostates (although there are methods to reduce the prostate so HIFU can be performed. And last, most insurance in the US still will not cover the cost even though it is FDA approved.
To answer your earlier question, my Gleason score is 6. One side is cancer and the other is pre-cancerous. The doctor and I are discussing if we should do both sides at once or just the cancer. Doing both areas at once has a higher chance of impacting quality of life while not doing both sides leaves a 25% chance that the pre cancerous area becomes cancerous. It's a tough call. The good news is HIFU can be repeated (so I can always have the other side done later) and HIFU does not disqualify you for other procedures should someone elect to pursue radiation or prostatectomy in the future.
There is no cutting, no radiation, does not disqualify other procedures, it can be repeated, and the recovery is quick (in most cases you can get up and go have lunch or dinner).
So those are the reasons why I'm electing to have the HIFU procedure.
barney34567 ES28567
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ES28567 barney34567
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Roger2Dodger ES28567
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barney34567 ES28567
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ES28567 Roger2Dodger
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The quote I received for proton radiation was in the $62,000 range. I don't remember how much they required upfront and then they make automatic withdraws from your checking account. HIFU is $25,000
Proton is radiation therapy. It is just a different type that in theory does not do as much damage to surrounding tissue. This is because they use "protons" instead of "photons". Protons penetrated the body so it is still external radiation but the radiation stops traveling when it gets to its destination. So, the radiation does not continue to travel through the body and therefore does not damaged additional tissues on the other side of the target. Personally, I think if a person is going to have external radiation, it is the way to go. But don't be fooled. It is still radiation and still damages healthy tissue and does cause side effects. Also, the entire process is treatment 5 days/week for 4 to 6 weeks straight so it's not just one quick treatment. If you don't happen to live near one of these centers, you must disrupt your life and move to their location for a good month or so. (However, I think a month out of your daily routine is more than a fair trade off to save your life, but it's not just a one day procedure and then on with your life). Also, like ALL radiation treatments, once the prostate has been cooked, there are very very few options left if the cancer comes back. You can still have a prostatectomy but it is messy, and takes a specialist far beyond the average urologist. One thing about the HIFU procedure Is it can be performed (either before or after radiation treatment). This is NOT radiation and instead uses ultrasound. It is "focal" so there are some advantages and disadvantages. It is also limited as to the size of prostate it can be performed on. However, as I stated, it can be performed after radiation therapy (which is rare) and HIFU does not disqualify someone from any other procedure they need should the cancer come back. Also, unlike many of the other procedures, HUFU is repeatable. Of all the procedures available, I think Proton and HIFU are the best options.
Unfortunately, insurance companies are SLOW to embrace new and better procedures until the evidence is so great they can no longer deny it. They don't think about the best interest of the patient (who also happens to be their CUSTOMER)...they only think about money. Both these procedures are FDA approved, have been performed close to 15 years now with proven results just as good as a prostatectomy with BETTER quality of life. Yet insurance only cares about saving a buck. I hate to say it but with all the media pressure on the importance of "women's health" if this was a procedure for women, it would have been covered by insurance AT LEAST 2 years ago!
Come on insurance...get you head out of your prostate!
Ok...now ask me how I really feel. Lol
nathan25612 barney34567
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barney34567 nathan25612
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Thanks for your answer. As an Australian if I go for proton therapy I must pay cash as Australian Insurance only covers treatments provided in Australia. And it isn't offered in Australia.
I have two questions: why did you chose procure in Oklahoma City and not a larger facility?
And, assuming you have proton therapy and in 5 years your PSA rose ( let's assume you are 50 or 60) does one repeat the therapy? Does one do something else? If so what?
Assume a high grade cancer.
nathan25612 barney34567
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I chose to have my proton therapy here in Oklahoma City, Ok. because I only live about 8 miles from the treatment center. Also, you can google Procure Prostate Center, Oklahoma City, Ok. and see that it is a very large center with about 72 people on staff. As far as one's cancer being in remission and returning, you would have to check with your doctor to see what type of treatment you would need for reoccurance. Alot depends on your particular situation and your individual needs.
barney34567 nathan25612
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You are right that I should check with the physician as to the PCa returning. My assumption is that its return depends on how successful the initial treatment is and I am now trying to compare the success rates across all the various therapies. I mean if one solution keeps it away for 5 years and another say for 8 years then that is important data for me to include in my analysis. Taking into account the side effects of course.
can you say what was your Gleason score?
when you say no side effects are you saying that sexual function, bowel and urinary do not suffer at all? Or suffered only a little which was tolerable.
nathan25612 barney34567
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My Gleason score was 7. I've had no change in sexual function, bowel or urinary function. I take Tamsulosin for urine flow but was taking it before I did the theapy. Keep in mind I'm 77 and not as able to 'perform' like I did when I was much younger; however, my sexual desires have not diminished.
barney34567 nathan25612
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good to hear about bladder and bowel functions being unaffected by PT. this I think is the strength of PT over conventional RT