John T said...
A couple of things about proton treatment:
1. It's 90's technology. There are better radiological technologies such as IMRT and seeds.
2. The wait at Loma Linda is extremely long. Check it out.
3. On Some of the radiology forums there is talk about pelvic bone loss due to Proton treatment, a lot of hip fractures and pending lawsuits. This is also worth checking out.
John T thanks for the link. Not surprising that it doesn't show up in a google search as it is a private mail list. I joined the list to read the topic referred to in your post and in fact have spent several hours reading posts in prostatepointers.org/mailman/private/ebrt going back at least 2 years and what I have discovered is this:
Your comment is disingenuous at best. There is no published clinical evidence that supports the claim of bone loss or fracturing with regard to PBT for prostate cancer and I will refer anyone to the same EBRT mail list where the info is contained.
The article I have linked below does mention an increase in spontaneous hip fracture in patients receiving radiation to treat pelvic tumors so I would imagine there IS some risk but it does not define the patient age or sexual orientation. In the very next sentence though they refer to post menopausal women as having poor survival rates from the fractures. This would not be unexpected as many would be borderline for an osteoporosis diagnosis in all likelihood.
In fact a physician with a nuclear medicine background who had proton treatment refuted the claim that protons are causing damage to the head of the femur and the pelvic socket by disrupting the blood supply to same by saying there is no clinical evidence that this is occuring. I would think with the number of patients being treated at the proton centers in this country, Japan and Europe that there would be more substantive evidence if this was now the case.
It appears that there is some evidence of bone loss associated with ADT but who would have thought that Androgen deprivation would lead to male osteoporosis .
ANY radiation exposure (including photons and neutrons and gamma rays) to bone can result in bone loss, which is a real concern to astronauts since crew members on the Space Station suffer bone loss in weightless conditions at 5 times the normal rate. However there are several studies with pediatric pelvic tumor patients that show that protons are beneficial and should be considered the preferred treatment for pediatric patients with certain types of cancers.
So basically your statement above is based on the single posting by a 76 year old man (at time of treatment) with diabetes, who one year later FELL and broke his hip and is having hip replacement and posted wondering about causality from Protons due to prior postings about bone loss due to proton/ photon treatment for prostate cancer.
There was one response to this gentleman with a referral to this article http://www.nsbri.org/Research/Projects/viewsummary.epl?pid=232 which while mentioning protons also refers to any radiation exposure. I would be more concerned by receiving IMRT and hormone therapy than I would be from receiving protons, alone or in combination.
54 years old (55 currently)
PSA 5.6 on 3/20/07
Biopsy on 4/20/07
3 out of 12 cores positive, 2 on the right lobe with 5% adenocarcinoma Gleason 3+3, 1 on the left lobe 10% adenocarcinoma Gleason 3+4, overall Gleason graded 7 Cancer T1C. After web research discovered Proton Beam Therapy and called Loma Linda. Completed consultation with Dr. Luu on 7/5/2007 and started treatment at Loma Linda on 7/26/07. Completed treatment 44 on 9/28/07. 0 treatments remain. Side Effects are zero. 1st PSA result on January 28th is 1.1. PSA result on July 17th, 2008 .73 . PSA result on January 22nd, 2009 .66 18 months removed from start of treatment.