CancerCompass message board discussion started by LindaCee on 10/11/2007 http://www.cancercompass.com/message-board/message/all,17000,0.htm Sun, 12 Oct 2008 00:00:00 GMT Sun, 12 Oct 2008 00:00:00 GMT http://backend.userland.com/rss RSS.NET: http://www.rssdotnet.com/ It's me again,Husband (70 ) still undeceided---first Dr. said he had METS to the bones & nodes---second said NO METS he would do surgery if he wanted but suggested he have radiation therepy because of his age & Parkinsons--we saw the radiation oncologist-- he of course he said radiation--- surgery or radiation  had the same results--- the problem is my husband is leaning to Robotic Surgery because he doesn't want to go to the Dr.for radiation for 8 weeks---you know how you guys hate Drs.---A guy 60 yrs old he works with said he had Robotic Surgery was back to work in 2 weeks----I believe everyone does not heal the same-- so really one can't go buy what one person says  ---we see a Dr at Ochner Wed.--Thank To All,Linda LindaCee Thu, 11 Oct 2007 00:00:00 GMT Dear Linda I don't know why your husband at 70 would want to subject himself to surgery and the potential very unpleasant side effects.  When I was diagnosed with PCa in late 2006 I boiled my choice down to robotic surgery and proton radiation therapy (a safer form of radiation compared to IMRT/IMGT x-ray radiation).  I chose proton radiation therapy at one of the major proton radiation treatment centers and have had virtually no lasting side effects after treatment.  I was told by a top medical oncologist at a major cancer hospital that my chances of eradicating my cancer were about equal with surgery and radiation treatment.  At 68, I decided that I did not want to go through months of recovery after surgery and having to deal with the surgical side effects which are sometimes worse for older patients.   Go to www.healingwell.com and have your husband read some of the postings from members about some of the nasty incontinence and impotence side effects after surgery.  Also read the following posting:http://www.healingwell.com/community/default.aspx?f=35&m I suggest that you consider reading a relatively new book entitled "You Can Beat Prostate Cancer (and you don't need surgery to do it) by Robert J. Marckini.  http://www.amazon.com/You-Can-Beat-Prostate-Cancer/dp/custom  Best of luck to your husband.  Let us know what he decides!  Dave On 10/11/2007 LindaCee wrote:It's me again,Husband (70 ) still undeceided---first Dr. said he had METS to the bones & nodes---second said NO METS he would do surgery if he wanted but suggested he have radiation therepy because of his age & Parkinsons--we saw the radiation oncologist-- he of course he said radiation--- surgery or radiation  had the same results--- the problem is my husband is leaning to Robotic Surgery because he doesn't want to go to the Dr.for radiation for 8 weeks---you know how you guys hate Drs.---A guy 60 yrs old he works with said he had Robotic Surgery was back to work in 2 weeks----I believe everyone does not heal the same-- so really one can't go buy what one person says  ---we see a Dr at Ochner Wed.--Thank To All,Linda   Pcdave Sat, 13 Oct 2007 00:00:00 GMT 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. Witchdoctor Sun, 14 Oct 2007 00:00:00 GMT 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.  Pcdave Mon, 15 Oct 2007 00:00:00 GMT before committing to this, at age 70, HiFu would be a far easier treatment, and one that has a much higher cure rate, and lower rate of side effects too. Pete W. Petewen Fri, 19 Oct 2007 00:00:00 GMT Keep in mind that HiFu has not been approved by the FDA as an acceptable treatment for prostate cancer in the U.S., although the beginning of clinical trials have apparently been approved.  This is still a relatively new treatment performed in Canada and other countries, but the jury is still out as to how effective this treatment is and what the longer term side effects may be.  I would tread carefully before undertaking this form of treatment until its merits have been proven.  Also, it may be difficult to get reimbursement from your health insurance plan and I do not believe that this treatment has yet been approved for reimbursement by Medicare. Dave   On 10/19/2007 Petewen wrote:before committing to this, at age 70, HiFu would be a far easier treatment, and one that has a much higher cure rate, and lower rate of side effects too. Pete W.  Pcdave Fri, 19 Oct 2007 00:00:00 GMT You are right about one thing.  Insurance will not pay for it.  You are wrong about everything else. This procedure has been approved by virtually every other nation on earth except the USA.  It is NOT a relatively new treatment. It's been done for almost 15 years in europe and Japan, and the results are excellent and well documented, albeit they are not advertised in the US because it would take too much lucractive business away from urologists and hospitals. Cure rates are BETTER than any other treatment, and side effects are LESS.  Before you make a decision you owe it to yourself to get educated on the subject, and not buy into the propaganda of those who are going to make money by getting you to agree to surgery or radiation, or drugs On 10/19/2007 Pcdave wrote:Keep in mind that HiFu has not been approved by the FDA as an acceptable treatment for prostate cancer in the U.S., although the beginning of clinical trials have apparently been approved.  This is still a relatively new treatment performed in Canada and other countries, but the jury is still out as to how effective this treatment is and what the longer term side effects may be.  I would tread carefully before undertaking this form of treatment until its merits have been proven.  Also, it may be difficult to get reimbursement from your health insurance plan and I do not believe that this treatment has yet been approved for reimbursement by Medicare. Dave   On 10/19/2007 Petewen wrote:before committing to this, at age 70, HiFu would be a far easier treatment, and one that has a much higher cure rate, and lower rate of side effects too. Pete W.   Petewen Sat, 20 Oct 2007 00:00:00 GMT