Prostate treatment options

Has anybody used it and can comment on it?

Is it worth insisting that it is used if you go the radiation way to minimize the risk of secondary radiation side effects?

Have meetings with my urologist and oncologist ( radiation) this week- different days

Will probably also see the surgeon another day

Summarising questions to ask as I meet them- have much better picture now than when I started

Have gathered quiet a bit from this forum

Thanks

As in the the UK some surgeons will be more highly regarded than others. Just because there are more men affected in total in the USA does not make surgeons more experienced, only that there will be more surgeons in the USA. The experience is limited to how many men a surgeon is able to operate on in a day which is likely to be two in either country. The techniques would be basically the same, although fewer hospitals have robotic surgery in the UK.

As far as radiation goes, there would be more choice in the USA because they additionally treat with Proton Beam for those that are suitable. Theoretically, Proton treatment should be superior to Photon because the energy is mainly released on the tumour and a much lower amount on it's way to and after the target as with Photon RT,(the so called Bragg Peak), so less collateral damage and the tumour is hit harder. This has proved to be very much the case with head tumours and indeed people are sometimes sent from the UK to the USA for this reason, the USA having the most Proton Beam facilities and the longest experience of this type of treatment. There are many patients and doctors in the USA who advocate this treatment for PCa also but there is a surprising lack of comparative data between this and other forms of RT. The advantage of using Proton beam to treat PCa over other forms of RT is less well defined. I did consider this back in 2008 when I was looking into other treatments but ruled it out on the grounds of cost, about three months overall in the States and check ups over there. I believe the number of fractions has now been reduced, so this would have an effect on time and cost.

The other forms of Photon RT available in the States are also available in the UK but not necessarily all at any one hospital.

Edited by member 08 Dec 2016 at 11:45  | Reason: Not specified

Lyn is right about this and it is certainly an aspect that should be established in advance. I was fortunate in that having decided to have my RT within a study in Germany, with EBRT supplemented by Carbon ions (which have an even higher RBE than Protons), the Royal Marsden agreed to monitor me and in due course referred me to UCLH for further treatment. So in my case I was able to get back into the NHS system and just as well!

The point is that there is no private equivalent to your NHS ED nurse / andrology clinic which means you would be dependent on either your private urologist or the relevant private hospital to be knowledgeable and up to date with current research etc and to write all prescriptions for pumps, pads, caverject (if needed) as the GP is unlikely to prescribe on a private consultant's say-so when it is going to come out of the GP's budget.

For my case she does not encourage Proton beam radiation -still trial and experimental

Brachytherapy -botherline- be ready for some immediate side effects

CyberKnife - first choice -tested and proven -will use SpaceOAR to minimize radiation to other organs-urine flow result excellent-will use bicalutamide to lower PSA for first three months -use markers-do MRI& CT scan and then 5days radiation. Side effects will be minimized e.g urinary urgency . Rectal and urinary side effects minimized.

She is confident if I want to go the radiation way this is the way to go.

Laser ablation - can be use as a salvage option if there are issues with radiation

Said no matter the treatment I choose -even surgery -ED will be worse

Always good to get an opinion on what treatment is considered best suited to you as an individual, as a standard approach may not be best for all patients. Also, regardless of how it all pans out, you can know you got advice from consultants familiar with your case and considered this as part of your decision, so in a sense some satisfaction in knowing you did all you could to get a good result in a situation where there are no certainties.

For John the pain started almost immediately and the moobs were obvious by 3 months. Unfortunately it is often a permanent side effect and it has taken him almost 5 years to get rid of them.

Noticed mild tiredness. Breast tenderness / enlargement also very mild. No other noticeable side effect .

Discussed this last week at visit to doctor - no need for extra medication since it is very mild and not bothering me.

Expecting advice / information from dietician team and physiotherapist to help with treatment.

PSA 5.9 two months ago now 3.45 last week.

Placement of fiducial markers / spacer OAR this coming Monday and CyberKnife radiation about 1/2 weeks after.

tiredness, Breast tenderness / enlargement mild. No other noticeable side effect.

PSA 5.9 three months ago ,3.45 a month ago now 3.06.

Postrate volume - 53 ml after biopsy last November now 30 ml this week.