Posted 5/7/2014 11:34 AM (GMT 0)
MD Anderson doing a clinical trial of 15 Proton sessions versus the normal 30 but still more than CK. Expense doesnt most likely matter IF you have insurance and the insurance will cover either or both. IF both of these conditions are met once you are diagnosed with a serious condition (not just prostate cancer) you will almost surely meet your out of pocket maximums so cost most likely isnt a major factor. The other criteria to consider is access to either or both of these options. The other difference is the method of placing Fiducials.
According to Dr Pugh, a man with my prostate cancer profile should look at Watch vs Treat. He felt watch was not a good option even though it was a possibility. So if treat is the best option then the goal should be a cure with the second goal is maximize quality of life (short and long term). He thought Surgery, EBERT, and EBERT and ADI would be the best options for a cure (in no order). Either of these should give an 85-90% chance of cure. Within EBRT is SBRT (CK), IMRT, And Proton.
Where I stand now: he will review have the MDA path review the biopsy slides to confirm GS, They drew blood so he will give me those results, Schedule an endo rectal MR (Parametric MR) he felt it was crucial to know any mets. Interesting to note I asked my Uro about the Para MR and he blew me off- Pughsaid it is because most surgeons dont change their approach regardless of what the MR shows. If all you have in your toolbox is a hammer then every problem looks like a nail. Finally he suggested additional opinions as needed by me or him.
So I have met with 4 MDs for this and am leaning towards Proton. I would more seriously consider CK but the placements of the Fiducials sounds tough- they use a needle through the buttocks vs going through the backside. Not much if any anesthesia for either.
Feel free to add to this or ask me any questions.