Myth #6: My doctor tells me that the only way to be sure I’m cured is to have the prostate removed from my body. With proton therapy, the prostate is left behind, so my chance of a recurrence is higher.
This is one we hear quite often. Many people are of the mistaken belief that it’s true, having the prostate removed guarantees a cure. And it would be true if 1) you were 100% sure the cancer was confined to the prostate and, 2) if the surgeon did not leave behind any part of the prostate.
But the fact is, in a large number of cases, the cancer has escaped the prostate into the tissue surrounding the prostate. This escape of cancer is almost always microscopic and thus cannot be seen by the surgeon, causing cancer to be left behind. Also, it is not uncommon for part of the prostate to be left behind following surgery, especially with the nerve sparing technique. If this tissue contains cancer cells, then again, you still have cancer.
Even with early stage, “garden variety” prostate cancer, there is good chance there are microscopic cancer cells in the tissue surrounding the prostate. These cancer cells left behind after surgery are the seeds for the re-growth of the cancer.
Let’s say your PSA is 5.2, your Gleason score is 3+3=6, and your stage is T1c. The Partin tables show that there’s a 67% chance your cancer is organ confined. This means there’s a 33% chance there is cancer in the tissue surrounding your prostate. The tables also show there is a 3% chance of seminal vesicle involvement. Surgery doesn’t remove the tissue surrounding the prostate and usually not the seminal vesicles.
Now, let’s assume your PSA is the same, 5.2, but your Gleason score is 7 and your staging is T2b. In this case, the Partin tables show a 25% chance of organ confined disease (75% chance of cancer in the tissue surrounding the prostate), and an 18% chance of cancer in the seminal vesicles.
One significant advantage of proton therapy is that the tissue surrounding your prostate is treated as well as the seminal vesicles. So, in our opinion, the chance of destroying all the cancer is greater with proton therapy than with surgery.
One Last Point
When BOB founder, Bob Marckini was in treatment almost 13 years ago, about 5% of the patients being treated at Loma Linda were men who had previously had their prostates removed surgically. About 350 members of our group (5.4%) had surgery to remove their prostates. They were not cured because cancer was left behind after surgery, and they chose proton for salvage treatment. So, clearly, having the prostate removed surgically does not guarantee a cure.
We believe your chances of a cure are better with proton therapy because it is designed to eradicate cancer cells where they are found: In the prostate, seminal vesicles, and tissue surrounding the prostate.
Add to that the fact that proton therapy is painless, non-invasive, carries no risk from infection or anesthesia, does not require a catheter, and generally leaves the patient with a better quality of life after treatment … and the treatment decision becomes quite easy.
Myth #6: BUSTED!
Any questions? Just ask.