Prostate Cancer Community
after RP, cancer in lymph node 4+5
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after RP, cancer in lymph node 4+5

A good friend had a radical prostatectomy in early December after a PSA of 10 and a biopsy revealing malignant cells in both lobes. The urologist removed a string of eleven lymph nodes during the procedure. One of the nodes had malignant cells and a Gleason rating of 4+5 was assigned. He has started hormone therapy. A bone scan is scheduled for mid-January and external beam radiation is scheduled for early March. He has been told in the past that his colitis condition may prevent radiation treatment or may result in a colostomy.

My friend can go anywhere for treatment. He is currently being treated at a lesser known regional cancer center with no proton facility and no particular reputation in molecular imaging. Certain cancer centers have proton therapy facilities and others have strong reputations in molecular imaging. Molecular imaging can aid in the detection of metastatized cancer, reducing the volume that proton therapy, for example, would need to target.

What is the best course for my friend? Should he seek treatment from a major center with proton facilities and leadership in fields like molecular imaging? Is proton therapy recommended after the prostate is removed? Does proton therapy offer an opportunity to avoid irradiation of the colon that could impact his colitis condition? How is it determined whether salvage proton therapy is appropriate?

Thank you for any ideas!
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Dear allankennard:  I had  prostate cancer in 2005 with a psa of 4.5 and gleason of 6.  I had Proton Radiation at Loma Linda University Medical Center in Loma Linda California.  Personally, I think Proton is the very best treatment there is today for Prostate cancer.  It has a 90% cure rate and little to no side effects.. I have -0- side effects as a result of the Proton Radiation treatment... approximately 90% of the treatment energy is delivered directly to the tumor  being treated so... therefore surrounding tissues and organs are not damaged as with traditional radiation....  thus ...little to no side effects.  I dont know about salvage proton.. Several hospitals now offer proton, but Loma Linda pioneered it in this country about 20 years ago..... My experience with Loma Linda is one of the most positive experiences I have ever had.. The people there are great... very caring and very concerned about curing your prostate cancer... Personally if I were in your friends place... I would head to Loma Linda University Medical Center as fast as I could go.  I shouldnt add this but I will, its my gut feeling that your friend would have been better of to have never had the radical surgery but had Proton Radiation to start with.. but whats done is done and he must go forward from here.. Im sure some doctor recommended the radical surgery... many doctors will not recommed proton because the dont have facilities to  offer it.. so they dont make money by sending patients elsewere... they recommend what ever treatment they are trained to do...which may or may not be in the patients best interest.... sad but true I believe.  I knew people at Loma Linda getting treatments whose numbers were worse than your friends and the Proton treatments cured their cancer... My treatments were 5 years ago and my PSA is now .03...I hope this is of some help. . If you have any questions about my experience with Proton Radiation, please send me a message and I will be glad to share any of my experience with you.. best of luck to you and your friend... Claytex
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