Prostate cancer treatment following colon cancer surgery

engr2025

I am interested to hear from list members who may have experienced prostate cancer treatments on the heals of colon cancer surgery. Ihad a routine PSA test in May 2025, which came back with 13. A urologist sent me for MRI in August 2025, which gave a pirads of 4. The clinic's only biopsy probe was broken, so my biopsy was scheduled for October 2025. In Sept, I went to the ER with a severe bellyache, which turned out to be a small bowel obstruction. Operation (laparotomy) for that turned up a nodule on my cecum, prompting an immediate colonoscopy while I was still in the hospital. Another nodule was inside the cecum. Both nodules were determined to be adenocarcinoma. Finally got my prostate biopsy in October, which came back as gleason 4+4 in 8% of one core, 3+4 in 35% of another core, and 3+4 in 45% of another core. In all, eight of 12 cores were deemed cancerous. None were cribriform, and the Polaris score was 3.6. Two weeks later I had a right hemi colectomy. Pathology showed no lymph node involvement, and negative margins, so it appears my colon cancer is now gone. Two more weeks and I had a PSMA PET-CT scan, which determined my prostate cancer is very localized. Lastly, I had a visit with a multispecialty team at Fred Hutchinson Cancer Center to explain my options for prostate cancer treatment.

The surgeon advised against prostatectomy, as my two recent abdominal surgeries have produced a jungle of adhesions and inflamation. I expected proton therapy to be the obvious choice, but the radiation oncologist cited the Partiqol study to suggest I would be just as well off with VMAT xray therapy from my local hospital rather than IMPT at Fred Hutch. This was a rather surprising recommendation that I am still pondering. The Partiqol study indicates that outcomes (bowel, bladder, ED, metastises, etc) were essentially identical for the proton therapy and the intensity modulated xray therapy. From reading stories on this site, though, it appears to me that the proton therapy involves just a few sessions, while the xray therapy is 40 or more sessions. I am very interested in reading comparisons of the two therapies from the patient's perspective.

Old Salt

Proton therapy may involve many sessions.

SBRT typically can be done in five or fewer sessions.

Proton therapy for prostate cancer - Mayo Clinic

swl1956

Photon or Proton, are equally effective. Both can done with longer course of treatment or also shorter course with higher gy radiation. There is slightly more risk with the shorter course treatments for toxicity but can be done in as little as five sessions. My oncologist did not recommend the short course due to having had an IRE ablation already. I had the 40 sessions. It's also common to hypofraction down to 25 sessions which I believe is very standard at this point.

Clevelandguy

Hi,

Proton has a fixed beam length which means very little damage past the intended target and it can be used in the same area once you have maxed out an area with conventional X-ray type radiation. If you go with Xray based check with your Oncologist about using the gel between your Prostate and Rectum. The gel absorbs or blocks the beam from damaging the Rectum.

Dave 3+4