Further Update
The story at the time of my last post was my intention to undertake PROTON Radiation Therapy rather than PHOTON Therapy, the last dose of which I received a few days ago.
Photon I could get on the NHS (either Halcyon or True beam). Proton for old geezers such as me is only available in the UK at UCLH, under the umbrella and final control of that institution, but fronted by Proton International London, with whom was my treatment agreement.
My treatment protocol was crafted for me (to include prophylactic radiation of the Pelvic Nodes)
Of real interest to me, and absolutely the information I needed to have, was an ability to compare and contrast the treatments offered by each provider.
The NHS were offering me 37 treatments (7 & ½ weeks Monday thru Friday at varying daily times to better suit the NHS rather than the patient), each comprising 74 Gy, for the Prostate and Seminal Vesicles and a lower dose of 60Gy for the Pelvic Nodes. Despite requests made over several months, I never did get to see the protocol behind either the treatment number or the dosage level
For my Proton treatment I was offered 40 treatments (4 weeks Monday thru Friday at constant daily times to better suit the my travel arrangements), each comprising 60Gy for the Prostate and Seminal Vesicles and a lower dose of 44Gy for the Pelvic Nodes.
The maths is simple. Besides Proton being a far less intrusive radiation delivery mechanism, the radiation dosages I received to cure me were 43% of the Photon dosage for the Prostate and Seminal Vesicles and 39% of the Photon dosage for the Pelvic Nodes.
I had a 90 minute commute into London each treatment day, and although by the Friday I was glad for the weekend break, other than some contact dermatitis caused by the cleaning fluids used, to date, I have suffered no side effects, except a slight fluidity when evacuating my bowels (which might have been exacerbated by the rubbish train station food I was eating!). I exercised daily, felt no pain when urinating or at any other time, no reddening/marking of the skin, or perceived tiredness and, other than being absolutely focused on the best way to ensure treatment success, I was able to lead a normal life throughout.
If you read my earlier posts you will see that I was not able to have an MRI scan made available by the NHS. However once I had moved over to becoming a private patient, I had a full prostate MRI which, according to my oncologist showed I had reacted extremely well to the HT I had been on for 8 months to the extent that there was no radiological evidence that I had infected prostate/vesicles/nodes. My last PSA result was down to 0.31 (from over 60 when I initially requested one)
When treating prostate cancer patients with radiation therapy, the goal is to destroy the cancer cells while avoiding damage to surrounding healthy tissue. Space-Oar is a mechanism to insert a gel between Prostate and Rectum, and is designed to diminish incidental damage to that part of the body, by separating the 2 organs by up to 1 cm. The gel is self dissolving over time.
Prior to the start of my Proton treatment I had an operation to insert Space-Oar gel in me.
During my course of treatment I had to prepare each day with a micro enema and would only be treated if my bladder was 'comfortably' full, again to better separate the prostate from surrounding tissue. I also continued to take my daily blood thinners, calcium and vitamin D3 to help minimise bone issues brought on by HT as well as my thrice weekly does of Tadalafil (Cialis) to help with the LUTS, which predated my treatment and was improved during the course of it..
I remain to be debriefed by my (private) oncologist, to report to my (NHS) oncologist, who remains very much interested in my Proton treatment, and to learn in detail about my post treatment expected PSA levels over time and my likely length on HT. I am also starting to concentrate on the testing benefits of Free PSA.
I do not want to bang on about my choices, but can say my decision to have Proton treatment was, for me and my family, the best possible investment. I fully understand that over the next few weeks/months my condition could worsen, and that there is the possibility of future PSA fluctuations and side effects appearing.
Should any of that happens, you will get to know, if only to provide a better understanding of the future situation..
Hello Crippo2
Thank you very much for updating us on your personal journey - I am aware from your pervious posts that much research has gone into your personal treatment path.
As I often say we are all on a "journey" here and we all take a different "route" but we all aim for the same "destination". I agree with your sentiments
I do not want to bang on about my choices, but can say my decision to have Proton treatment was, for me and my family, the best possible investment
And I am so pleased it has worked for you - I do hope this treatment stands the test of time and wish you well moving forward. Please do keep us updated with your progress.
To help others understand how you got to where you are are you able to put some sort of journey timeline in your profile (you can read mine by clicking on my name or avatar) as this would be a great help to others. To do this click on the chair on your home page (top right) then "Profile" and then "Edit" - don't forget to save it once you have written something.
Many thanks and Best wishes - Brian.
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