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Need some help with making a decision on treatment IMRT (Calypso) or PBT

Posts: 1
Joined: Jul 2014

I was diagnosed with prostate cancer in May 2014.  Gleason of 6, PSA 4 with one biopsy core at ~5% out of 12 positive.  I know that this is a very early stage and I often feel like I am the exception in being diagnosed this early.  I am 50 so I don't think watchful waiting is really the right course of action to take since my PSA has risen from 1.2 in 2009 to now 4.  So my guess is that within 1-2 years it will be closer to 10 and be considered in stage 2.  I have ruled out surgery.  I don't think that it is neccesary in my case.  I don't want to become incontinet and impotent at this point in life.  The only other option is radiation.  I have visited two treatment centers. One using IMRT with the Calypso markers and Proton beam.  I am going to visit a Cancer Treatment Center of America that is near my home which is the Chicago area.  My worry with radiation is the long term risk of secondary cancers. I am leaning toward PBT but want to make sure that I haven't misssed anything with photon therapy.  Can anyone give me some advice on either treatment.  Does anyone have any experience with Cancer Treatment Centers?  When I setup a consult they immediately want to run a Bone Scan, CT and MRI.  I didn't have that happen with the other two centers. I understand that a CT will be done once the fiduciary markers are placed in the prostate.  Any advice would be appreciated.

Posts: 37
Joined: Nov 2011

CTC is run like a car dealer. They load on the options. Learned this from an Oncoligist who quit there and went to Fox Chase.

Yank31's picture
Posts: 15
Joined: Dec 2013

When I was diagnosed with PCa in November 2013, they started with the tests the same day. First, it was x-ray then CRT. The bone scan was done later the next week.

The doctor did not really expect to find cancer in the scans but wanted a good set of early scans to establish a baseline for reference farther down the road. My cancer was thought to be contained in the capsule but was scored as a Gleason 8 (high risk). Perhaps the higher GL score prompted the scans upon diagnosis? I am not sure.

Your numbers are lower, so you should ask the doctor if the tests are absolutely necessary at this stage. I was under the impression that they are always done upon a positive diagnosis, regardless of the stats.

Good luck.

Old Salt
Posts: 23
Joined: Aug 2014

1. PBT is radiation as well (with protons); long-term side effects are not known at this time

2. PBT is sort of the latest, but quality clinical studies to show that this method is better (or equivalent) to IMRT or brachytherapy (other potential options) are lacking, AFAIK

3. PBT is much more expensive than IMRT or brachytherapy; you may want to find out how much will be reimbursed by your insurance company

4. Have you considered Cyberknife (officially, Stereotactic Body Radiation Therapy; SBRT). Although I am by no means a medical professional, your status seems to indicate that that method might be an option as well.


Good luck on your journey; there's no need to make hasty decisions in your situation.

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