Treated 2002 · Posted 2003
"When all factors and parameters are taken into account it (Proton treatment) is the preferred way to go."
My experience with the proton is somewhat different from that of most other "graduates" of the program. I am age 81, an alumnus of the School of Medicine, Loma Linda University, Class of 1953-A, hence I "grew up" with an awareness of the proton. I did not, as others diagnosed with cancer of the prostate, have to become acquainted with its potential. I had had a tour of the proton treatment facilities during its earlier operational stages, but I was not knowledgeable about its comparative status with all the other treatment modalities available.
I am not aware of any history of cancer of the prostate (PCa) in my immediate family. My earlier PSAs and DREs were unremarkable. I had these two items checked regularly about every 6 -- 12 months by a number of different doctors, all of whom came up with the same findings. Gradually the PSA rose from 4.0 to 6.0 along with the usual symptoms of urinary frequency and urgency which persisted for several years. I suspected I had benign prostatic hypertrophy or hyperplasic (BPH), So not to worry. My wife Sylvia and I are snowbirds; we spend the winter months in the Palm Springs area of southern California. About three years ago we attended a symposium on BPH and PCa presented by a well-known urologist in Indio. He mentioned the use of microthermy as a treatment for selected cases of BPH. When I went to see him he assured me that first we must rule out any possible malignancy. He found I had a PSA of 6.5 and on DRE I had a small, non-tender prostate with a suspicious area. Next was an ultrasound-guided biopsy - about 12 - 15 "snaps"- with no anesthesia (ouch). I wasn't surprised or "shocked" when the pathologist's report came back a Gleason 6. In the urologist's opinion I had a well encapsulated Ca of the prostate without penetration into the prostatic bed.
Next step: How shall we treat it. Knowing that PCa is usually a slowly progressive tumor, at age 81 there was a good chance that I would reach my demise via an entirely different route. I have coronary artery disease with a three-vessel bypass surgery in 1991. But, I recall many times in my life members of my family accusing me of being "just like your mother"!! Ever heard that? My mother died at age 95 !! A bit of quick arithmetic told me I had a better than average chance of living beyond my 81 years. After discussing the various modes of approach to the treatment possibilities - watchful waiting, surgeries, radiations including brachytherapy, the photon (the proton wasn't mentioned), hormones, chemotherapy, and cryotherapy, we spent some time looking at the "seeds" - how nice: only one day to place them and you go home a nuclear generating plant !! I gathered from my urologist friend that he opted for radical prostatectomy, although he did not at this time say so. Had he been more positive about this approach I had an answer. As a doctor I had seen and heard of all kinds a after surgery incidents - the pain, the incontinence with the long weeks of an indwelling catheter, the stretch of having to re-establish a once again normal plumbing system. We elected to go for the watchful waiting option. This included a repeat PSA and DRE every six months. This was done twice noting that the PSA continued to gradually but persistently rise to 7.5. At this point we decided to abandon the passive watchful waiting mode for a more active and aggressive choice. What shall it be? Decision time. For me, here came the "kicker". I asked my urologist friend, "What do you think about the proton radiation program at Loma Linda?" His reply, as he pointed westward to Loma Linda with his thumb, "Well they think it's great". Nothing more was said. I inferred that he knew about the proton, but he had reservations. I began to cast about seeking those I knew who had been "protoned". They all assured me - no pain, few or no side effects, a very pleasant experience, their PSA went down and stayed down. They would do it again if need be. They advised me, go for it: you won't regret it.
We (Sylvia and I) went for it. I was pleased with the pre-treatment evaluation Very smooth Very efficient. Very courteous. Cheerful. Helpful. Our medical insurance support is Medicare and Mail Handlers (we were both prior federal employees). We had no questions about Medicare picking up the tab. We called the Mail Handlers home office to ascertain their willingness to pay for the proton treatments. Their answer was, "Oh, yes, we are well aware of the program. Go for it, and good luck". I started treatment on February 7, 2002. Every day, M - F for 40 days. I had NO side effects. For about a week or ten days I was not sure I was going to be able to urinate, but I don't like catheters or sounds, so I "got well" fast !! We drove from Desert Hot Springs to Loma Linda, every day - 55 miles one way - on dangerous I-10.
We got acquainted with five pleasant and happy sojourners from Seattle, Boston, Virginia and Montana. Friends we will remember for a lifetime, No fear of the dread devil, cancer, here. We will forever remember the upbeat cheerful atmosphere of the Proton Treatment Center. Lots of cancer-unafraid people from all over the world gathered in one place. What a place. Wonderful experience. I graduated and became, after signing up, a member of BOB, on April 5, 2002. I am now Seely 4/02. And may I add very humbly and appreciatively, I admire my alma mater. Blame me?
Four months post-treatment I feel fine. No treatment aftermath. I started treatment with a PSA of 8.9 ng/ml. My first post treatment check was done on August 5 with a PSA of 2.5. I expect each subsequent PSAs to be progressively markedly lower. One more note. While at Loma Linda we did not attend any of the Wednesday evening support groups held in the Schumann Pavilion. Didn't know what we were missing. After reading all the weekly BOB Tales reports we now realize we missed a lot. Since our proton experience I am an avid researcher and advocate of the proton treatment program at Loma Linda. I am thoroughly convinced, as an M.D., that the treatment of choice for the solid tumor (no escaping the capsule) of PCa is the well-managed application of the conformal proton beam. When all factors and parameters are taken into account it is the preferred way to go. So you guys out there, 40 or 50 years of age or older, seek a PSA and a responsible DRE regularly - every 6 - 12 months. An early diagnosis is the key. And one of the best evaluator of the journey is he who has been there; done that. Listen to him and go for it
Howard C .Seely, M.D.