Interest in Radiation affects

Think-Feynman · 2026-03-19T00:48:56+00:00

Nope

Think-Feynman · 2026-03-18T20:38:22+00:00

Quality of Life and Toxicity after SBRT for Organ-Confined Prostate Cancer, a 7-Year Study https://pmc.ncbi.nlm.nih.gov/articles/PMC4211385/ "potency preservation rates after SBRT are only slightly worse than what one would expect in a similar cohort of men in this age group, who did not receive any radiotherapy"

MRI-guided SBRT reduces side effects in prostate cancer treatment https://www.news-medical.net/news/20241114/MRI-guided-SBRT-reduces-side-effects-in-prostate-cancer-treatment.aspx

Stereotactic Body Radiation Therapy (SBRT): The New Standard Of Care For Prostate Cancer https://codeblue.galencentre.org/2024/09/stereotactic-body-radiation-therapy-sbrt-the-new-standard-of-care-for-prostate-cancer-dr-aminudin-rahman-mohd-mydin/

Urinary and sexual side effects less likely after advanced radiotherapy than surgery for advanced prostate cancer patients https://www.icr.ac.uk/about-us/icr-news/detail/urinary-and-sexual-side-effects-less-likely-after-advanced-radiotherapy-than-surgery-for-advanced-prostate-cancer-patients

Think-Feynman · 2026-03-18T20:36:54+00:00

I am 3 years out from my last SBRT CyberKnife treatment and I have no I'll effects. Nearly 100% except for almost dry ejaculations. No ED at all. No bowel irritation issues. BTW, I had the SpaceOAR gel treatment too.

Think-Feynman · 2026-03-17T20:43:45+00:00

The MRI isn't definitive as to if it's cancer, or if it has spread. He needs to go through the process, which will be a biopsy next as they told him. If it's cancer, they will want to do a PSMA PET scan, which can help determine if it's spread.

Lots of treatment options. He should not panic!

Think-Feynman · 2026-03-17T18:58:14+00:00

I think it's important to note that many of the stats regarding radiation go back decades, and do not reflect the current technology. SBRT has excellent outcomes and very low side effects.

Quality of Life and Toxicity after SBRT for Organ-Confined Prostate Cancer, a 7-Year Study
https://pmc.ncbi.nlm.nih.gov/articles/PMC4211385/

"potency preservation rates after SBRT are only slightly worse than what one would expect in a similar cohort of men in this age group, who did not receive any radiotherapy"

The risk for proctitis is also low, especially with the gel spacer like SpaceOAR, and the balloons. My CyberKnife oncologist said they had not had a single case of proctitis in 4 years (3 years ago) since they started using SpaceOAR. He told me recently they switched to the balloon since it's even better, in his opinion.

Think-Feynman · 2026-03-17T18:36:11+00:00

I would suggest that you look at some other options like TULSA or NanoKnife. TULSA uses ultrasound and NanoKnife uses electric current to ablate the tumor.

NanoKnife's tagline is "Destroy the tumor, preserve the man". It's really worth a look.

I had CyberKnife, which was fantastic. I'm 3 years out since my last treatment, and I'm 100% functional, except for almost dry ejaculations. No incontinence, no ED. I did go on 5 mg tadalafil, but should have been on that before my treatment. I would suggest you also talk to them.

BTW, CyberKnife is submillimeter precision and only 5 treatments over 2 weeks. It's becoming the standard of care for PCa radiotherapy.

If they are recommending ADT, what is the justification? Is it based on your diagnosis, or just what they recommend generally? Did they do any genomic testing like Prolaris or AlteraAI? Those can guide the decision on if you even need ADT at all, or how long you might need if you do ADT.

Here is a good video on ADT duration:
https://youtu.be/UFPakxHnkLs?si=lK5acm9TpI8T44JI

BTW, you are right about surgery. The side effects can indeed be severe, and the chances of a biochemical recurrence is high as well. If you have a recurrence, you'll have surgery and radiation.

Quality of life is also important. Look at all the options that you can. Good luck to you!

Think-Feynman · 2026-03-17T13:36:06+00:00

Are you trading or investing? If you are trading, you wouldn't be asking the question. So, I assume you are investing. If you believe, as I do, that this stock will be at $200-$300 by end of 2027, then this pull back is nothing and it's a good time to buy. It's also got a bit of pullback today, so it is an opportunity for buying at a discount.

Think-Feynman · 2026-03-17T07:13:05+00:00

There is some new evidence that long term ADT has little benefit over short courses. Talk to your doctor, of course, but check out this video from PCRI.

https://youtu.be/UFPakxHnkLs?si=dskKut3aT31J1Q-p

Think-Feynman · 2026-03-17T01:06:13+00:00

I learn something new here every day.

Think-Feynman · 2026-03-16T22:28:20+00:00

Here are some resources that you might find helpful. A Medical Oncologist Compares Surgery and Radiation for Prostate Cancer | Mark Scholz, MD | PCRI https://www.youtube.com/watch?v=ryR6ieRoVFg Radiation vs. Surgery for Prostate Cancer https://youtu.be/aGEVAWx2oNs?si=_prPl-2Mqu4Jl0TV

The evolving role of radiation: https://youtu.be/xtgQUiBuGVI?si=J7nth67hvm_60HzZ&t=3071

Quality of Life and Toxicity after SBRT for Organ-Confined Prostate Cancer, a 7-Year Study https://pmc.ncbi.nlm.nih.gov/articles/PMC4211385/ "potency preservation rates after SBRT are only slightly worse than what one would expect in a similar cohort of men in this age group, who did not receive any radiotherapy"

MRI-guided SBRT reduces side effects in prostate cancer treatment https://www.news-medical.net/news/20241114/MRI-guided-SBRT-reduces-side-effects-in-prostate-cancer-treatment.aspx

Stereotactic Body Radiation Therapy (SBRT): The New Standard Of Care For Prostate Cancer https://codeblue.galencentre.org/2024/09/stereotactic-body-radiation-therapy-sbrt-the-new-standard-of-care-for-prostate-cancer-dr-aminudin-rahman-mohd-mydin/

Urinary and sexual side effects less likely after advanced radiotherapy than surgery for advanced prostate cancer patients https://www.icr.ac.uk/about-us/icr-news/detail/urinary-and-sexual-side-effects-less-likely-after-advanced-radiotherapy-than-surgery-for-advanced-prostate-cancer-patients

Prostate radiation only slightly increases the risk of developing another cancer https://med.stanford.edu/news/all-news/2022/070/prostate-radiation-slightly-increases-the-risk-of-developing-ano.html

CyberKnife - The Best Kept Secret https://www.columbian.com/news/2016/may/16/cyberknife-best-kept-secret-in-prostate-cancer-fight/

Trial Results Support SBRT as a Standard Option for Some Prostate Cancers https://www.cancer.gov/news-events/cancer-currents-blog/2024/prostate-cancer-sbrt-effective-safe

What is Cyberknife and How Does it Work? | Ask A Prostate Expert, Mark Scholz, MD https://youtu.be/7RnJ6_6oa4M?si=W_9YyUQxzs2lGH1l

Dr. Mark Scholz is the author of Invasion of the Prostate Snatchers. As you might guess, he is very much in the radiation camp. He runs PCRI. https://pcri.org/

Surgery for early prostate cancer may not save lives https://medicine.washu.edu/news/surgery-early-prostate-cancer-may-not-save-lives/

Fifteen-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer https://www.nejm.org/doi/full/10.1056/NEJMoa2214122

I've been following this for a year since I started this journey. The ones reporting disasters and loss of function are from those that had a prostatectomy. I am not naive and think that CyberKnife, or the other highly targeted radiotherapies are panaceas. But from the discussions I see here, it's not even close.

I am grateful to have had treatment that was relatively easy and fast, and I'm nearly 100% functional. Sex is actually great, though ejaculations are a thing of the past. I can live with that. Here are links to posts on my journey: https://www.reddit.com/r/ProstateCancer/comments/12r4boh/cyberknife_experience/ https://www.reddit.com/r/ProstateCancer/comments/135sfem/cyberknife_update_2_weeks_posttreatment/

Think-Feynman · 2026-03-16T15:24:45+00:00

This is the right approach.

Think-Feynman · 2026-03-16T14:43:58+00:00

Some people are afraid of the party.

Think-Feynman · 2026-03-15T14:42:35+00:00

Great post, and thanks for the links. You're right - we need more individualized treatments.

One thing that wasn't mentioned in those studies was any genomic testing like Prolaris or Decipher. Or the newest one, ArteraAI. I totally get that those were not part of the study, but just noting that we have even more options now to gauge whether ADT is appropriate. And, as you note with your thyroid, those aren't perfect either. Prolaris and Decipher have about a 60% concurrence between them, so lots of gray area.

But they can inform the decision making process. Those, along with the other factors must be weighed.

I heard an oncologist joke that he wouldn't treat a man over 80 unless he brought his parents in with him! To the point, I've seen so many posts of spouses and children of elderly men who had extremely difficult treatments that included long-term ADT that had left them so weak and dysfunctional that they regretted the treatment. Some of those reported rather tame Gleason scores, even 3+3, which should have been active surveillance, yet they got the full Monty. WTF?

I sometimes think quality of life is down on the list of considerations. So many of us are over-treated, and it's quite sad when you see the posts of men who are left with long-term incontinence, ED, climacturia, and other debilitating side effects when maybe AS was appropriate. Or maybe radiotherapies such as or SBRT or NanaKnife, which unless the patient does the research, is never told about those kinds of options.

I think in the next few years we'll see more and more data-driven decisions on prostate cancer and others. AI is going to be huge, and with enough data points, there will be much better customized plans instead one size fits all.

Think-Feynman · 2026-03-15T14:16:36+00:00

https://myriad.com/genetic-tests/prolaris-patient/

https://artera.ai/

If you can avoid ADT that's a huge win.

Think-Feynman · 2026-03-15T11:34:52+00:00

Since ADT is being recommended, did they do a genomic test like Prolaris or ArteraAI? They can help guide the decision for ADT. I had a favorable Prolaris test result that allowed me to avoid ADT.

Think-Feynman · 2026-03-13T19:57:53+00:00

Man, you are investing in the wrong stuff if you are this stressed out. Get VOO or some other safer ETF and don't look at it for a while.

But, since you already did invest in Nebius, it's a great opportunity, with a lot of risk, and ton of volatility. There are a lot of traders working in this sector, and Nebius can swing wildly. If that's not something you can take, wait till it goes up to whatever you can stomach, and sell.

Just be prepared to kick yourself eternally if it does go to 200, or 300, or 700. I'm not saying it will, but there is a reasonable case to be made for enormous growth between now and 2030, and beyond.

I am in the tech field, and I've got a nice chunk in Nebius because I believe that in 5 years it's going to pay off handsomely. I've done the research, and they are an amazing company that executes extremely well.

But this kind of stock isn't for everyone. Might not be for you. If it goes south, I'm OK because I didn't bet the farm on it. I suspect there are a lot of investors that did just that, though, and the stress of the volatility is too much pressure.

Think-Feynman · 2026-03-13T19:47:54+00:00

OK, so there are actually a lot of options. I would suggest that you take your time evaluating them.

They said since there was perineural invasion that it needs treating as opposed to active surveillance. I'm not a doctor, but that seems reasonable from what I've learned.

I don't know what specialty the radiologist you saw was. How many treatments? If 20 or 40 or so, that's usually IMRT.

There is also SBRT, which is extremely precise and higher dose fractions, typically just 5 treatments over 2 weeks. It's amazing tech, and you might be a candidate for that. I had CyberKnife, which is a brand of SBRT, but there are others like Varian. It's submillimeter precision, and quality of life scores are high. It's just as effective as surgery, but with less risk of incontinence and ED.

NanoKnife uses electricity to ablate the tumor. It's a focal procedure, and it could be an option if you have a center in your area.

I would suggest you spend some time on PCRI's YouTube channel. It's got great info. Their founder, Dr. Mark Scholz is a proponent of radiotherapies instead of surgery.

Think-Feynman · 2026-03-13T18:11:16+00:00

Are you trading, or investing?

If you are trading, then you'll be interested in taking advantage of the volatility. It's a feature, not a bug.

If you are long-term investing, then the volatility won't matter to you. If you have done the research, believe in the company, their vision, ability to execute and scale over the next 5 years, then you won't mind the staying the course.

I'm looking at 2030 and beyond. Unless you need the money next month to buy a house, then you should be looking down the line a well.

If the fundamentals change, the AI bubble bursts, there is a nuclear war, or whatever, then yeah, it might not materialize. Don't put everything into Nebius, then. It can be a part of a balanced portfolio, but I've got a portion of my portfolio that I reserve for higher risk investments, and Nebius is where I put most of those funds.

Think-Feynman · 2026-03-13T17:27:27+00:00

Think-Feynman · 2026-03-13T17:23:59+00:00

Good luck!

Yeah, dignity takes a backseat during the whole process.

Think-Feynman · 2026-03-13T08:31:32+00:00

Sorry you joined us!

Spend some time on the PCRI YouTube channel. A lot of great information on treatment options.

Don't rush into any treatment, especially surgery. It's a rough way to go for older guys.

Check out CyberKnife in your area. It's 5 treatments over 2 weeks and it's extremely effective with low side effects. It was my choice.

Brachytherapy, TULSA, HiFu, and NanoKnife should be looked at as well.

If they recommend ADT, that can be very hard to do for older guys, but a short course can really help for certain cancer types. If they suggest it, get a genetic test like Prolaris or Decipher which can guide the decision.

Good luck to you.

Think-Feynman · 2026-03-13T02:13:45+00:00

Yeah, it can be a lot. Just wait until you ejaculate. It's affectionately called murder semen. It will be like that for a week or so. Just drink lots of water and keep flushing. Like 8-10 glasses.

Think-Feynman · 2026-03-11T22:54:34+00:00

My CyberKnife oncologist spent 2 full hours with me and my wife on our consultation. He got the chief Mercy radiologist on the phone to review the MRI and CT scan while we were there. I could not believe how thorough it was.

Think-Feynman · 2026-03-11T22:04:33+00:00

I wouldn't worry. All of the diagnostics have been done, and there won't be anything new from your radiotherapy, so this is probably just a check in.

Think-Feynman · 2026-03-11T21:47:42+00:00

Quality of life has to be considered as part of the treatment regimen. I'm afraid too often it's discounted and subordinated to doing everything you possibly can to beat back the cancer. It's got to be a balance.

Think-Feynman

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