The results of the scan are in and I've consulted with the RO. I read the results prior to meeting with him.
3 small discrete intensely tracer avid pelvic lymph nodes most consistent with progressive metastatic adenopathy. Left common illiac, 2 left internal illiac. The largest (left internal) measured 0.8 x 0.7 cm with SUV Max of 14.6. The other 2 measured SUV Max were 11.4 and 11.7. There was nothing of note in the head, neck, chest regions. It was also reported that the previously identified intensely tracer avid focus in the leftward prostate on prior PET MR (Jan 2023) has resolved. So it seems the radiation worked I take it. (On the Jan 2023 report, the PiRad 4 lesion was left posterior apex peripheral zone with SUV Max of 20.7 abuts the left prostatic capsule w/o evidence of frank extraprostatic tumor extension). I'll never really know if cells escaped or whether this new lymph node activity was always in the pelvic bed and just caught with the new "gold standard" imaging.
The plan is to radiate the pelvic bed with 25 fractions, 60 Gy either standard radiation or Proton therapy depending if insurance covers Proton. 6 months of Orgovyx. He also suggests consulting with an MO about possibly adding abiraterone to the mix. That consult is scheduled for 2/24/26.
dx:55yo;4.4
3/17bx:3/12+G6;5%-20%;MRI:7/17-(1)PIRAD 3
4/18bx:4/12+G6;5-30%; MRI:1/19(-)
7/19-3.9;2/20-2.7; MRI:2/20(-);12/20-4.0; MRI:3/21(-)
6/21-3.6; MRI:4/22,(1)PIRAD 4; 6/22-3.7; 1/23-4.3
1/23-PETMRGaPSMA:no locoreg/no distant disease
(1)PIRAD4 no EXE
5/23 IMRT-28 Tx,70 Gy at Emory Winship Cancer
Institute/Atlanta
8/23-2.12;2/24-1.12;8/24-1.15;3/25-1.11;10/25-3.56;12/25-5.49
Interesting - There has not been much discussed about re-irradiation after primary radiation. It is hard to search for as most articles assume recurrence after surgery which is the primary use case.
I was able to find a few studies which were based on HDBR and SBRT secondary treatments. Also found one with standard IMRT which I assume was more focal in nature. Then I stopped looking and reading.
There seemed to be minimal long term data but did not find much discounting the idea. There was discussion about side effects which you would expect with any radiation treatment, so you have another opportunity for those. Treating BCR after RT has always been an issue as radiating an area twice never seemed like a good idea. Apparently, doing nothing but ADT is not a great idea either so I can see why doing something is the better approach. Removing the prostate after RT never seemed to be great solution to me given almost guaranteed side effects, removing lymph nodes might be a possibility though.
Good luck with your next meeting.
7/2018 (66yr), PSA 4.1->5.1
8/2018-MRI PI-RADS 5, MRI guided biopsy, 8/14 cores, G7(4+3)
9/2018-CT/Bone scans clear
11/6/18-RALP Surgery
11/2018-Post-Op Path G7(4+3) Tert Gr5, pT3a pN0, Grp 3, SM, EPE, <3mm
11/2018-Decipher 0.47, Ave Risk
1/2019-Epstein-G9(4+5) Grp 5, pT2x, margin vs. incision not clear
4-6/2019 ART 37 sessions
PSA<0.10: 2019, 2020, 2021, 2022, 2023, 2024, 2025
I was able to find a few studies which were based on HDBR and SBRT secondary treatments. Also found one with standard IMRT which I assume was more focal in nature. Then I stopped looking and reading.
There seemed to be minimal long term data but did not find much discounting the idea. There was discussion about side effects which you would expect with any radiation treatment, so you have another opportunity for those. Treating BCR after RT has always been an issue as radiating an area twice never seemed like a good idea. Apparently, doing nothing but ADT is not a great idea either so I can see why doing something is the better approach. Removing the prostate after RT never seemed to be great solution to me given almost guaranteed side effects, removing lymph nodes might be a possibility though.
Good luck with your next meeting.
7/2018 (66yr), PSA 4.1->5.1
8/2018-MRI PI-RADS 5, MRI guided biopsy, 8/14 cores, G7(4+3)
9/2018-CT/Bone scans clear
11/6/18-RALP Surgery
11/2018-Post-Op Path G7(4+3) Tert Gr5, pT3a pN0, Grp 3, SM, EPE, <3mm
11/2018-Decipher 0.47, Ave Risk
1/2019-Epstein-G9(4+5) Grp 5, pT2x, margin vs. incision not clear
4-6/2019 ART 37 sessions
PSA<0.10: 2019, 2020, 2021, 2022, 2023, 2024, 2025
I was entering deep into the rabbit hole for a week with Dr. AI so I'll never be able to recreate it. Something about oligmetastatic prostate cancer/nodal recurrence where a pelvic bed radiation is possible if it wasn"t radiated the first time. He said that it wasn't so I guess there's that. I think I'm going to ask him again if I heard correctly.
dx:55yo;4.4
3/17bx:3/12+G6;5%-20%;MRI:7/17-(1)PIRAD 3
4/18bx:4/12+G6;5-30%; MRI:1/19(-)
7/19-3.9;2/20-2.7; MRI:2/20(-);12/20-4.0; MRI:3/21(-)
6/21-3.6; MRI:4/22,(1)PIRAD 4; 6/22-3.7; 1/23-4.3
1/23-PETMRGaPSMA:no locoreg/no distant disease
(1)PIRAD4 no EXE
5/23 IMRT-28 Tx,70 Gy at Emory Winship Cancer
Institute/Atlanta
8/23-2.12;2/24-1.12;8/24-1.15;3/25-1.11;10/25-3.56;12/25-5.49
dx:55yo;4.4
3/17bx:3/12+G6;5%-20%;MRI:7/17-(1)PIRAD 3
4/18bx:4/12+G6;5-30%; MRI:1/19(-)
7/19-3.9;2/20-2.7; MRI:2/20(-);12/20-4.0; MRI:3/21(-)
6/21-3.6; MRI:4/22,(1)PIRAD 4; 6/22-3.7; 1/23-4.3
1/23-PETMRGaPSMA:no locoreg/no distant disease
(1)PIRAD4 no EXE
5/23 IMRT-28 Tx,70 Gy at Emory Winship Cancer
Institute/Atlanta
8/23-2.12;2/24-1.12;8/24-1.15;3/25-1.11;10/25-3.56;12/25-5.49
My choice for pelvic lymph node mets after RP and salvage RT to bed was salvage lymph node surgery using the frozen section pathology method. It has been eight years and all is well, still no ADT.
Benign biopsy at 47-PSA 20.4. Metastatic at 57-PSA 10.1. RP in 2016 followed by SRT to bed. 2018 advanced imaging and SePLND in Europe. Since June 2021 uPSA holding 0.03X, still no ADT. DX'ed metastatic melanoma Sep 2024. Have learned twice to not give cancer time and obscurity. Maintaining excellent health and fitness. Grateful! Murray Keith Wadsworth, author, podcaster: sheeporwolfcancer.com
Benign biopsy at 47-PSA 20.4. Metastatic at 57-PSA 10.1. RP in 2016 followed by SRT to bed. 2018 advanced imaging and SePLND in Europe. Since June 2021 uPSA holding 0.03X, still no ADT. DX'ed metastatic melanoma Sep 2024. Have learned twice to not give cancer time and obscurity. Maintaining excellent health and fitness. Grateful! Murray Keith Wadsworth, author, podcaster: sheeporwolfcancer.com
I thought that re-irradiation was complex and usually avoided because of the risk of severe tissue toxicity.
69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx
2013 TURP for BPH (90-->30 g) no PCa
6-6-17 Nodule (R) + PSA on finasteride: 3.6-->4.3
Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM, nodule neg
Bone scan, CTs: neg, 8-7-17 open RP @Duke, neg frozen sections, nerves spared
SM EPE BNI LVI SVI LNI(16): neg, PNI+, pT2c pN0 R0 MX, G9 (4+5) 5%, 64 g
Decipher 0.37 Low Risk, PSA 0.010 (3m)…0.234 (8+ yr)
69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx
2013 TURP for BPH (90-->30 g) no PCa
6-6-17 Nodule (R) + PSA on finasteride: 3.6-->4.3
Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM, nodule neg
Bone scan, CTs: neg, 8-7-17 open RP @Duke, neg frozen sections, nerves spared
SM EPE BNI LVI SVI LNI(16): neg, PNI+, pT2c pN0 R0 MX, G9 (4+5) 5%, 64 g
Decipher 0.37 Low Risk, PSA 0.010 (3m)…0.234 (8+ yr)
My update. I will undergo the proton radiation therapy treatment which started 3/10/26 actually. When I asked my RO about re-radiation, he said that the first time atound, only the prostate was radiated. This time only the pelvic bed and the 3 lymph nodes will be radiated using proton and the radiation will stop at the source and not continue. After speaking with an MO, I've decided to add the abiraterone to the Orgovyx and go the 24 month route. I've been on Orgovyx for 5 weeks and haven't come across any unpleasant side effects. I started the abiraterone yesterday 3/14/26. Interesting fact about Proton Centers is that there is one monster 90 ton cyclotron that supplies the radiation to the 5 treatment rooms. The delivery is somewhat shared in that Room 1 gets a 1' delivery. Then Room 3 may get the next one, then Room 4, then back to Room 1 then Room 2. So the time on the table may be as long as 30' but the radiation time is 3 deliveries about 1' apiece. So these Centers are open from around 8am to close to 11pm. I'm not a fan of that. Tomorrow my treatment starts at 10:10pm for example. The rest of the week between 4:50-6:50pm. There's currently 47 Proton Centers in the US they seem to be set up the same way generally. I think the idea is that over time, technology will figure out a way to possibly make the cyclotrons smaller at a lower cost and maybe cover 1 or 2 rooms. So maybe more centers can be built to service more people. The cost to complete the Emory Proton in Atlanta cost ~$220M back in 2018 as an example. Just in case anyone is interested how this works.
dx:55yo;4.4
3/17bx:3/12+G6;5%-20%;MRI:7/17-(1)PIRAD 3
4/18bx:4/12+G6;5-30%; MRI:1/19(-)
7/19-3.9;2/20-2.7; MRI:2/20(-);12/20-4.0; MRI:3/21(-)
6/21-3.6; MRI:4/22,(1)PIRAD 4; 6/22-3.7; 1/23-4.3
1/23-PETMRGaPSMA:no locoreg/no distant disease
(1)PIRAD4 no EXE
5/23 IMRT-28 Tx,70 Gy at Emory Winship Cancer
Institute/Atlanta
8/23-2.12;2/24-1.12;8/24-1.15;3/25-1.11;10/25-3.56;12/25-5.49
dx:55yo;4.4
3/17bx:3/12+G6;5%-20%;MRI:7/17-(1)PIRAD 3
4/18bx:4/12+G6;5-30%; MRI:1/19(-)
7/19-3.9;2/20-2.7; MRI:2/20(-);12/20-4.0; MRI:3/21(-)
6/21-3.6; MRI:4/22,(1)PIRAD 4; 6/22-3.7; 1/23-4.3
1/23-PETMRGaPSMA:no locoreg/no distant disease
(1)PIRAD4 no EXE
5/23 IMRT-28 Tx,70 Gy at Emory Winship Cancer
Institute/Atlanta
8/23-2.12;2/24-1.12;8/24-1.15;3/25-1.11;10/25-3.56;12/25-5.49
ejc, we wish you the very best of outcomes for your treatment!
Djin
69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx
2013 TURP for BPH (90-->30 g) no PCa
6-6-17 Nodule (R) + PSA on finasteride: 3.6-->4.3
Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM, nodule neg
Bone scan, CTs: neg, 8-7-17 open RP @Duke, neg frozen sections, nerves spared
SM EPE BNI LVI SVI LNI(16): neg, PNI+, pT2c pN0 R0 MX, G9 (4+5) 5%, 64 g
Decipher 0.37 Low Risk, PSA 0.010 (3m)…0.281 (8+ yr)
Djin
69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx
2013 TURP for BPH (90-->30 g) no PCa
6-6-17 Nodule (R) + PSA on finasteride: 3.6-->4.3
Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM, nodule neg
Bone scan, CTs: neg, 8-7-17 open RP @Duke, neg frozen sections, nerves spared
SM EPE BNI LVI SVI LNI(16): neg, PNI+, pT2c pN0 R0 MX, G9 (4+5) 5%, 64 g
Decipher 0.37 Low Risk, PSA 0.010 (3m)…0.281 (8+ yr)
ejc61 said...
My update. I will undergo the proton radiation therapy treatment which started 3/10/26 actually. When I asked my RO about re-radiation, he said that the first time atound, only the prostate was radiated. This time only the pelvic bed and the 3 lymph nodes will be radiated using proton and the radiation will stop at the source and not continue. After speaking with an MO, I've decided to add the abiraterone to the Orgovyx and go the 24 month route. I've been on Orgovyx for 5 weeks and haven't come across any unpleasant side effects. I started the abiraterone yesterday 3/14/26. Interesting fact about Proton Centers is that there is one monster 90 ton cyclotron that supplies the radiation to the 5 treatment rooms. The delivery is somewhat shared in that Room 1 gets a 1' delivery. Then Room 3 may get the next one, then Room 4, then back to Room 1 then Room 2. So the time on the table may be as long as 30' but the radiation time is 3 deliveries about 1' apiece. So these Centers are open from around 8am to close to 11pm. I'm not a fan of that. Tomorrow my treatment starts at 10:10pm for example. The rest of the week between 4:50-6:50pm. There's currently 47 Proton Centers in the US they seem to be set up the same way generally. I think the idea is that over time, technology will figure out a way to possibly make the cyclotrons smaller at a lower cost and maybe cover 1 or 2 rooms. So maybe more centers can be built to service more people. The cost to complete the Emory Proton in Atlanta cost ~$220M back in 2018 as an example. Just in case anyone is interested how this works.
I seem to recall when they installed Proton at Mayo, huge numbers like that and the same multiple room concept. There are extremely thick concrete walls constructed also since stopping protons is no trival task amongst other things. They are now expanding the facility with the same type of huge numbers with a $100 mil donation to get it going, opening in 2027?
I am in Atlanta and followed the Emory Proton construction and delayed opening closely as my radiation oncologist had the inside information. Emory was forced to back out of ownership when the cost reached over the original $225 million and was nowhere complete. Another firm, Provident Resources Group formed a subsidiary, Georgia Proton Care Center, and bought and finished the construction contracting Emory to operate and staff the center. Total construction cost was over $400 million and two years longer than planned, significantly delaying the opening.
Emory has been operating, but doesn’t own, the proton center through their Winship Cancer Center. about 60 days ago, Georgia Proton Care Center filed for bankruptcy. In the proceedings, Emory has made an offer to purchase the center from GPCC/Provident Resources Group.
Information from my radiation oncologist indicates that the center has not reached a break even point forcing the bankruptcy. He said the utilization has been far lower than original projections due in large part to low PCa utilization. While under construction, Medicare and most insurance companies began limiting reimbursement to an amount comparable to traditional IMRT external beam radiotherapy. This was a big financial hit the center couldn’t overcome due to the original cost overruns. I haven’t seen what Emory is offering as the “stalking horse bidder” in the vernacular of the bankruptcy court. Clearly they will be favored unless another outside firm bids considerably higher.
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard and Jalyn started on 10-7-2010. IMRT to prostate and lymph nodes started on 11-8-2010, HDR Brachytherapy December 6 and 13, 2010.
PSA < .1 since February 2011. Located in Cumming Georgia north of Atlanta
Emory has been operating, but doesn’t own, the proton center through their Winship Cancer Center. about 60 days ago, Georgia Proton Care Center filed for bankruptcy. In the proceedings, Emory has made an offer to purchase the center from GPCC/Provident Resources Group.
Information from my radiation oncologist indicates that the center has not reached a break even point forcing the bankruptcy. He said the utilization has been far lower than original projections due in large part to low PCa utilization. While under construction, Medicare and most insurance companies began limiting reimbursement to an amount comparable to traditional IMRT external beam radiotherapy. This was a big financial hit the center couldn’t overcome due to the original cost overruns. I haven’t seen what Emory is offering as the “stalking horse bidder” in the vernacular of the bankruptcy court. Clearly they will be favored unless another outside firm bids considerably higher.
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard and Jalyn started on 10-7-2010. IMRT to prostate and lymph nodes started on 11-8-2010, HDR Brachytherapy December 6 and 13, 2010.
PSA < .1 since February 2011. Located in Cumming Georgia north of Atlanta
There are few places that can find money like Mayo. They are a non-profit organization that posted a $1.5 billion profit in 2025 while every other medical group in MN including the University are having hard times. So they expand their proton capability when others can’t make the numbers work. They are also making large investments in AZ and FL where all the Medicare $’s are. No substitute for donations and endowments by rich people.
7/2018 (66yr), PSA 4.1->5.1
8/2018-MRI PI-RADS 5, MRI guided biopsy, 8/14 cores, G7(4+3)
9/2018-CT/Bone scans clear
11/6/18-RALP Surgery
11/2018-Post-Op Path G7(4+3) Tert Gr5, pT3a pN0, Grp 3, SM, EPE, <3mm
11/2018-Decipher 0.47, Ave Risk
1/2019-Epstein-G9(4+5) Grp 5, pT2x, margin vs. incision not clear
4-6/2019 ART 37 sessions
PSA<0.10: 2019, 2020, 2021, 2022, 2023, 2024, 2025
7/2018 (66yr), PSA 4.1->5.1
8/2018-MRI PI-RADS 5, MRI guided biopsy, 8/14 cores, G7(4+3)
9/2018-CT/Bone scans clear
11/6/18-RALP Surgery
11/2018-Post-Op Path G7(4+3) Tert Gr5, pT3a pN0, Grp 3, SM, EPE, <3mm
11/2018-Decipher 0.47, Ave Risk
1/2019-Epstein-G9(4+5) Grp 5, pT2x, margin vs. incision not clear
4-6/2019 ART 37 sessions
PSA<0.10: 2019, 2020, 2021, 2022, 2023, 2024, 2025
I just finished reading the Emory Proton Center bankruptcy filing of January 26, 2026 and the current status. The center was financed in 2015 with tax exempt bonds issued by Atlanta and underwritten and sold by CitiGroup in the amount of approximately $550 million. There are two stakes, Senior and Subordinate in roughly equal portions. This covered the land acquisition, facility construction, Cyclotron, gantries, treatment room equipment, and initial working capital. The bonds are at 6.75% and are due in 2035. The center reported an operating loss of $27 million in 2025.
Recently Emory submitted a stalking horse bid of $110 million in order to purchase all assets and operational rights and contracts of the center. At that level, the Senior holders would take a 65% haircut and the Subordinate holders would receive nothing. The bonds are currently trading for an average of 20 cents on the dollar. The formal auction will be held in April with a results hearing following to confirm the purchaser and final amount. I have not heard nor seen any reporting as to what Emory’s top bid might be or whether there are other bidders.
I remember when Emory pulled out there was a work stoppage as the original contractor paused and then retracted due to uncertainty of payment. This lasted about 18 months as Provident Resources assembled its plan and offer. Subsequently a second contractor was hired to resume and complete the construction. This prompted the bond issue and eventual completion of the center being significantly delayed. At the time it was obvious that Emory Healthcare could not afford to burden the University with such a financial exposure due to the projected adverse operating fiscal situation and prospect of limited reimbursement for PCa treatment that was going to be the operational cash cow. Obviously their concerns were well founded as the center has never broken even.
The Emory situation appears to have slowed the development of additional centers as the financial realities changed the business model. There are currently 47 in operation with three more coming on board in 2026-27 in Connecticut, Pennsylvania and Nebraska. A few more are in the planning or construction stage in Florida, Utah, Michigan and California.
The Emory Center has the capacity to treat more than 100 patients each day. Since opening in late 2018 it has treated approximately 5,800 unique patients through February 2026 or about 700 new patients per year. The center has five treatment rooms, four with rotating gantries and one with a fixed gantry for PCa treatment. So at least 20% of its capacity is committed to PCa. I have not yet found any breakdown as to the number of PCa patients treated as Emory does not provide public information detailing the number of treatmemts or patients by cancer type. Emory Proton continues to advertise heavily for PCa treatments. In the past several years I have met several men that went to Emory for Proton therapy that were diverted to IMRT/IGRT and/or Brachytherapy within the Emory system. Most were due to limited reimbursement for Proton therapy and a couple wanted to use brachytherapy with IMRT.
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard and Jalyn started on 10-7-2010. IMRT to prostate and lymph nodes started on 11-8-2010, HDR Brachytherapy December 6 and 13, 2010.
PSA < .1 since February 2011. Located in Cumming Georgia north of Atlanta
Recently Emory submitted a stalking horse bid of $110 million in order to purchase all assets and operational rights and contracts of the center. At that level, the Senior holders would take a 65% haircut and the Subordinate holders would receive nothing. The bonds are currently trading for an average of 20 cents on the dollar. The formal auction will be held in April with a results hearing following to confirm the purchaser and final amount. I have not heard nor seen any reporting as to what Emory’s top bid might be or whether there are other bidders.
I remember when Emory pulled out there was a work stoppage as the original contractor paused and then retracted due to uncertainty of payment. This lasted about 18 months as Provident Resources assembled its plan and offer. Subsequently a second contractor was hired to resume and complete the construction. This prompted the bond issue and eventual completion of the center being significantly delayed. At the time it was obvious that Emory Healthcare could not afford to burden the University with such a financial exposure due to the projected adverse operating fiscal situation and prospect of limited reimbursement for PCa treatment that was going to be the operational cash cow. Obviously their concerns were well founded as the center has never broken even.
The Emory situation appears to have slowed the development of additional centers as the financial realities changed the business model. There are currently 47 in operation with three more coming on board in 2026-27 in Connecticut, Pennsylvania and Nebraska. A few more are in the planning or construction stage in Florida, Utah, Michigan and California.
The Emory Center has the capacity to treat more than 100 patients each day. Since opening in late 2018 it has treated approximately 5,800 unique patients through February 2026 or about 700 new patients per year. The center has five treatment rooms, four with rotating gantries and one with a fixed gantry for PCa treatment. So at least 20% of its capacity is committed to PCa. I have not yet found any breakdown as to the number of PCa patients treated as Emory does not provide public information detailing the number of treatmemts or patients by cancer type. Emory Proton continues to advertise heavily for PCa treatments. In the past several years I have met several men that went to Emory for Proton therapy that were diverted to IMRT/IGRT and/or Brachytherapy within the Emory system. Most were due to limited reimbursement for Proton therapy and a couple wanted to use brachytherapy with IMRT.
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard and Jalyn started on 10-7-2010. IMRT to prostate and lymph nodes started on 11-8-2010, HDR Brachytherapy December 6 and 13, 2010.
PSA < .1 since February 2011. Located in Cumming Georgia north of Atlanta
Well I've completed my treatment at said center on 4/17/26. A pretty nice experience overall, aside from the Center's financial situation. I also started Orgovyx in February and Abiraterone in March. So far the side effects from the meds have been pretty ok (minimal). I had my first PSA draw today, 5/5/26, and it came back <0.01. So the journey continues.
The hours of operation run from about 8am to 11pm. I had about 3 sessions scheduled after 8:40pm the latest at 10:20pm but scheduling started getting earlier, starting at about 6pm and ultimately down to 2pm. As far as billing per individual per day, they billed ~$4,500.00 per day to insurance and the allowable amount was ~$1,900.00. This probably varies by insurance company. It seems that Proton Centers are trying to build smaller cycletrons and as a result, a smaller number of rooms. Looking at the one in CT. Sort of like when there where monster sized computers with tiny amount bytes and as time went on, computers got smaller and and GB kept increasing. Or not.
dx:55yo;PSA4.4
3/17bx:3/12+G6;<20%;MRI:7/17-PIRAD 3
4/18bx:4/12+G6;<30%;
MRI:7/18(PIRAD 3);MRI:2019-2021(-)
MRI:4/22(PIRAD 4) PSA 1/23-4.3
1/23-PETMRGaPSMA:no locoreg/no distant/no EXE
5/23 IMRT-28Tx,70Gy-Emory Winship Cancer
Institute
8/23-2.12;2/24-1.12;8/24-1.15;3/25-1.11;10/25-3.56;12/25-5.49
2/26 Orgovyx+Xytiga
4/26 Proton Therapy-25Tx,60Gy-Emory Proton Therapy Center
5/26 PSA <0.01
The hours of operation run from about 8am to 11pm. I had about 3 sessions scheduled after 8:40pm the latest at 10:20pm but scheduling started getting earlier, starting at about 6pm and ultimately down to 2pm. As far as billing per individual per day, they billed ~$4,500.00 per day to insurance and the allowable amount was ~$1,900.00. This probably varies by insurance company. It seems that Proton Centers are trying to build smaller cycletrons and as a result, a smaller number of rooms. Looking at the one in CT. Sort of like when there where monster sized computers with tiny amount bytes and as time went on, computers got smaller and and GB kept increasing. Or not.
dx:55yo;PSA4.4
3/17bx:3/12+G6;<20%;MRI:7/17-PIRAD 3
4/18bx:4/12+G6;<30%;
MRI:7/18(PIRAD 3);MRI:2019-2021(-)
MRI:4/22(PIRAD 4) PSA 1/23-4.3
1/23-PETMRGaPSMA:no locoreg/no distant/no EXE
5/23 IMRT-28Tx,70Gy-Emory Winship Cancer
Institute
8/23-2.12;2/24-1.12;8/24-1.15;3/25-1.11;10/25-3.56;12/25-5.49
2/26 Orgovyx+Xytiga
4/26 Proton Therapy-25Tx,60Gy-Emory Proton Therapy Center
5/26 PSA <0.01
Post Edited (ejc61) : 5/5/2026 4:09:48 PM (GMT-4)
Good to hear. Your reported PSA is great. Since you were on ADT since February, you would expect your PSA to be pretty low but this seems better than that and indicative that the RT might have done its job. Cancer is a tricky beast but you have a few years to not worry about it now.
7/2018 (66yr), PSA 4.1->5.1
8/2018-MRI PI-RADS 5, MRI guided biopsy, 8/14 cores, G7(4+3)
9/2018-CT/Bone scans clear
11/6/18-RALP Surgery
11/2018-Post-Op Path G7(4+3) Tert Gr5, pT3a pN0, Grp 3, SM, EPE, <3mm
11/2018-Decipher 0.47, Ave Risk
1/2019-Epstein-G9(4+5) Grp 5, pT2x, margin vs. incision not clear
4-6/2019 ART 37 sessions
PSA<0.10: 2019, 2020, 2021, 2022, 2023, 2024, 2025
7/2018 (66yr), PSA 4.1->5.1
8/2018-MRI PI-RADS 5, MRI guided biopsy, 8/14 cores, G7(4+3)
9/2018-CT/Bone scans clear
11/6/18-RALP Surgery
11/2018-Post-Op Path G7(4+3) Tert Gr5, pT3a pN0, Grp 3, SM, EPE, <3mm
11/2018-Decipher 0.47, Ave Risk
1/2019-Epstein-G9(4+5) Grp 5, pT2x, margin vs. incision not clear
4-6/2019 ART 37 sessions
PSA<0.10: 2019, 2020, 2021, 2022, 2023, 2024, 2025
Can’t figure out his new site. Its very sressful for me at least. Just want to report that my second PSA taken 8/26 was also <0.01.
Good to hear about PSA, bad to hear about new site issues. The new site is just another one of those things in life to contend with. If you start with the assumption that there is usually a way to do what you want to do then it becomes figuring it out as you go.
If you have any specific questions, would be glad to help. Now that we can post images, it is a little easier to provide help with a screen shot.