Witchdoctor
I agree with most of what you say, but
I take STRONG exception to your saying that proton radiation treatment
is experimental. Such treatment has been around for several decades
(e.g., Harvard University began "proton" treatment in 1961 for other
medical conditions and treated the prostate beginning in 1979. Proton
treatment started at Loma Linda University and Medical Center in 1990
and prostate treatment began in 1991). If it is experimental, then why
have several new proton treatment centers opened in recent years in the
U.S. and why are more scheduled to open? For example, In the United
States, proton therapy is currently available in five major academic
centers: Midwest Proton Radiotherapy Institute at Indiana University,
Bloomington, Ind.; Frances H. Burr Proton Therapy Center at
Massachusetts General Hospital, Boston (affiliated with Harvard Medical
School); The Proton Therapy Center at MD Anderson Cancer Center at
University of Texas, Houston; Loma Linda University Medical Center, in
Loma Linda, Calif..; University of Florida Proton Therapy Institute,
Jacksonville, Fla. In Philadelphia, the University of Pennsylvania
Health System Proton Therapy Treatment Center is scheduled to open in
2008. The Oklahoma City center is expected to be operational in 2009.
Lastly, if proton therapy is experimental, why has it been approved by
Medicare for reimbursement, notwithstanding that it is one of the
costliest prostate cancer treatments available?
One of the
reasons that you and others may think that proton radiation treatment
is experimental is that there have been few centers offering this
treatment compared to x-ray radiaiton until recently. It costs well
over $100 million to establish a proton radiation treatment center and
the great expense, not the validity of the treatment, is the reason why
it has been slow to emerge. It is now becoming of age and even less
expensive forms of proton radiation treatment are in the process of
being developed.
It is a know fact that proton radiation beams,
unlike x-ray radiation beams enter the body at a low dose and build up
to the desired higher dose when they hit the target, after which the
radiation stops. X-ray radiation, however, enters and leaves the body
at the highest doses needed to hit the target. Accordingly, there is a
much greater chance of damaging good tissue in the surrounding area
being radiated. Other than this benefit for proton radiation, which I
believe is a major benefit, there are no longer term definitive studies
which have effectively compared the longer term cure rate and side
effects of both proton and x-ray radiation treatment.
"Protons
have a physical advantage over x-rays when it comes to sparing normal
tissues. Protons deposit most of their radiation energy in what is
known as the Bragg peak, which occurs at the point of greatest
penetration of the protons in tissue. The exact depth to which protons
penetrate, and at which the Bragg peak occurs, is dependent on the
energy of the proton beam. This energy can be very precisely controlled
to place the Bragg peak within a tumor or other tissues that are
targeted to receive the radiation dose. Because the protons are
absorbed at this point, normal tissues beyond the target receive very
little or no radiation".
One last point--proton radiation is not
used exclusively for for treating cancer of the prostate gland. Proton
therapy has also been found to be effective in treating breast, lung,
colorectal, head and neck and brain tumors, among others. Proton
therapy can be particularly effective in treating children, who are
more sensitive than adults to the effects of radiation. In fact, when
I was being treated, many younger children were being treated for brain
cancer and other forms of cancer. The reason for this is that their
young bodies cannot tolerate x-ray radiation as well as proton
radiation.
Please do some more research on the internet and
you will hopefully become more aware of the merits of proton radiation
treatment.
Dave
On 10/14/2007
Witchdoctor wrote:
I would vote for irradiation as well do to the age and health problems. You don't say what the details of the cancer are??? gleason score, stage, pSA number of biopsies etc. If there is a significant chance of spread outside the prostate then irradiation is the way to go with or with our ADT.
Robotic surgery is no better than a classical prostatectomy studies have shown.
Patients can work during radiation treatments full time in almost all cases.
Proton beam is experimental and there is NO Proof it offers any advantages over current methods of delivering external beam. As a matter of fact if the lymphnodes or tissues around the prostate should be treated then it is inferior and sometimes has to be combined with external photon irradiation.
Currently for most stages of Cancer IMRT, implant or a combination will give better than ninety percent cure. With virtually no long term effects ie 1.5 percent rectal bleeding and virtually no incontinence. Much lower than surgery.